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Treatment of stage II medication-related osteonecrosis of the jaw with necrosectomy and autologous bone marrow mesenchymal stem cells

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Abstract

Treatment strategies for medication-related osteonecrosis of the jaw (MRONJ) remain controversial. Although the AAOMS suggests a conservative approach, a surgical management with necrosectomy is often required when conservative management has failed. Moreover, recent studies have shown promising results using an early stage surgical treatment. Over the past decade, cell-based bone regeneration utilizing bone marrow mesenchymal stem cells (MSCs) received increased attention. MSCs are known to promote wound healing and induce new bone formation in compromised tissue. Accordingly, the aim of this study was to assess the role of MSCs in the management of MRONJ. This study included 6 patients referred to our department with the diagnosis of MRONJ. Upon informed consent, the patients underwent surgical resection of necrotic bone followed by MSCs grafting. The MSCs were separated from bone marrow cells aspirated from the iliac crest using a bone marrow aspirate concentrate system. The MSCs were grafted into the defect with autologous thrombin and the defect was covered with a collagen membrane. In all cases, bony edges were rounded and the wound was closed using a three-layered technique. In the follow-up from 12 to 54 months, all patients including those who had impaired conditions, sepsis, or pathological fracture, showed satisfactory healing with no signs of wound infection. This pilot study indicated that surgical management in combination with MSCs transplantation seems to be a promising treatment modality in the therapy of MRONJ.

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Change history

  • 05 February 2019

    In the Original publication of the article, the co-author has been misspelled as Fabian Duttenh?fer in the article ?Treatment of stage II medication-related osteonecrosis of the jaw with necrosectomy and autologous bone marrow mesenchymal stem cells? published in October 2017, Volume 105, Issue 4 of Odontology. The correct name is ?Fabian Duttenhoefer?.

  • 05 February 2019

    In the Original publication of the article, the co-author has been misspelled as Fabian Duttenh��fer in the article ���Treatment of stage II medication-related osteonecrosis of the jaw with necrosectomy and autologous bone marrow mesenchymal stem cells��� published in October 2017, Volume 105, Issue 4 of Odontology. The correct name is ���Fabian Duttenhoefer���.

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Acknowledgements

Funding

This study was supported by the Osteology Foundation Grant No. 08-026.

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    Authors and Affiliations

    1. Department of Oral and Maxillofacial Surgery, University Medical Center Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany

      Pit Jacob Voss, Rainer Schmelzeisen, Fabian Duttenhöfer & Philipp Poxleitner

    2. Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

      Akihiko Matsumoto

    3. Section of Orthodontics and Maxillofacial Surgery, Latinamerican University of Science and Technology, 100 metros sur del Periódico La República, San José, Barrio Tournón, Costa Rica

      Esteban Alvarado

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    1. Pit Jacob Voss
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    Correspondence to Akihiko Matsumoto.

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    This study was approved by the local Ethics Committee of the University of Freiburg (Nr. 242/09).

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    Akihiko Matsumoto have contributed equally to this work.

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    Voss, P.J., Matsumoto, A., Alvarado, E. et al. Treatment of stage II medication-related osteonecrosis of the jaw with necrosectomy and autologous bone marrow mesenchymal stem cells. Odontology 105, 484–493 (2017). https://doi.org/10.1007/s10266-017-0295-4

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