Purpose: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well recognized pathologic entity which is challenging and difficult to manage. Recent literature contains several articles with most recommending a conservative management. In this study, we report a treatment modality for advanced cases of BRONJ which involves marginal bone resection and autologous platelet-rich plasma (PRP).

Patients and methods: This case series comprised 25 patients with BRONJ lesions and a history of intravenous bisphosphonate therapy for metastatic bone diseases which did not respond to conservative treatment. All patients were surgically managed by a standardized protocol combining marginal bone resection and PRP topically.

Results: Of the 25 patients, 20 (80%) showed a complete wound healing during the follow-up. Median follow-up was 36 months. Microscopic examination revealed actinomyces in 15 specimens.

Conclusion: BRONJ has been shown to be refractory to a conservative management. Treatment of refractory BRONJ with a combination of marginal bone resection and PRP has shown to be an effective therapy in most of patients and should be considered an alternative treatment modality for management of advanced cases.

Conflict of interest: None declared.