Efficacy of concentrated growth factors preventing medication-related osteonecrosis of the jaw following tooth extraction in patients on intravenous bisphosphonates: A randomized controlled trial.

BACKGROUND/PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) constitutes a severe postoperative complication following tooth extraction in patients with intravenous bisphosphonates (BPs) exposure. This study aimed to evaluate concentrated growth factors (CGF) in preventing MRONJ and enhancing tissue healing after tooth extraction in intravenous BPs treated patients. MATERIALS AND METHODS: This randomized controlled trial enrolled 119 patients (150 extraction sites). Extraction sites were randomly allocated to minimally invasive extraction alone (control, N = 75) or with CGF (test, N = 75). MRONJ incidence was assessed at least 8 weeks postoperatively. Gingival buccolingual width and fissure area were measured immediately after extraction and at 1, 2, and 4 weeks postoperatively. RESULTS: In the total cohort and the intravenous BPs combined with denosumab cohort, the incidence of MRONJ in the test group was significantly lower than that in the control group (P =0.028 and P=0.022, respectively). The test group showed significantly greater reduction in postoperative gingival buccolingual width at 1, 2 and 4 weeks and gingival fissure area at 1 and 2 weeks compared to controls (P < 0.05). MRONJ patients had greater intravenous BPs injection times than those without MRONJ (P < 0.001). CONCLUSION: Minimally invasive tooth extraction with CGF may effectively reduce the risk of MRONJ and promote tissue healing in patients treated with intravenous BPs, particularly those receiving concomitant denosumab therapy.