Background and objectives : Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an important complication in cancer patients taking intravenous Bisphosphonates. In most cases, BRONJ is associated with an oral surgery procedure involving jaw bone. Recent literature contains several articles, with most recommending conservative management. The management of BRONJ currently is a dilemma.We report our experience of the management of 10 patients with cancer and advanced and refractory BRONJ with a combination of bone resection and Platelet-Rich Plasma.

Methods : A total of 10 patients suffering from BRONJ at different sites had been treated with intravenous bisphosphonates for various oncological disease. The patients were treated by resection of the necrotic bone with primary closure of the mucosa over the bony defect using Autologous Platelet-Rich Plasma.

Results : Of the 10 patients treated with this protocol, 8 recovered with complete mucosal healing and no signs of exposed necrotic bone observed during the follow-up period, and pain subsided 2-3 weeks after surgery. Median follow-up was 10 months.

Conclusions : Treatment of refractory BRONJ with a combination of bone resection and Platelet-Rich Plasma was found to be an effective therapy in most patients and should be considered an alternative treatment modality for management of advanced cases.

Key words : platelet-rich plasma; bisphosphonate; osteonecrosis