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Study aim
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This study aimed to evaluate the effect on clinical healing of a combined treatment consisting of laser-assisted surgery and Platelet rich plasma (PRP) in cancer patients affected by bisphosphonates related osteonecrosis of the jaw (BRONJ)
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Design
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Cancer patients affected by BRONJ, single arm, not randomized
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Settings and conduct
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1) Clinical Evaluation;
2) Computer Tomography (CT) evaluation; lesions’ classification following SIPMO-SICMF staging system; scaling (when required) and oral hygiene instructions; pre-operatory medical therapy prescription; Platelet rich-plasma (PRP) preparation;
3) Surgical procedure: Er,Cr:YSGG Laser surgery, PRP application,Flap suture;
4) Suture removal and clinical control;
5) Follow-up visits at 15 days, one month, three, six, twelve months;
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Participants/Inclusion and exclusion criteria
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Patients were eligible for the study if they had: 1) age ≥ 18 years; 2) cancer; 3) treatment with bisphosphnates (BPs) because of the underlying cancer. Patients were excluded from the study if they had: 1): previous history of irradiation to the maxillofacial area; 2) neoplastic involvement of the jaws; 3) previous surgical treatment to the jaws; 4) poor general conditions.
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Intervention groups
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The surgical protocol consisted of: 1) elevation of a full-thickness mucoperiosteal flap to expose the surgical area; 3) bony curettage (debridement) and sequestrectomy of the necrotic bone, whether required, using a Er,Cr:YSGG laser; 4) application of autologous PRP; 5) tension-free soft tissue closure
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Main outcome variables
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We defined successful treatment the absence of clinical and radiological signs of BRONJ relapse (healing) or, in turn, the transition from a higher stage to a lower one (improvement).