Simultaneous Application of Bone Morphogenetic Protein-2 and Platelet-Rich Fibrin for the Treatment of Bisphosphonate-Related Osteonecrosis of Jaw

(a) Panoramic view taken at the first visit showing a nonhealing lesion at the right mandible. (b) Photograph taken at the first surgery presenting necrotic bone. Minimal surgical debridement was performed.

(a) Panoramic view taken 2 weeks after the second surgery. Note the extended bone lesion at the inferior border of the mandible. (b) Image taken right after suture removal after the second surgery. Note the purulent discharge and persistent inflammation. (c) Image taken after the second surgery showing extraoral fistula.

(a) Preparation of recombinant human bone morphogenetic protein-2 (rhBMP-2) and sectioned collagen sponge carrier. (b) Application of the rhBMP-2 smeared collagen carrier. (c) Application of platelet-rich fibrin above the rhBMP-2 carrier.

(a) Photograph taken 6 weeks after simultaneous application of platelet-rich fibrin and recombinant human bone morphogenetic protein-2 showing the fully resolved lesion. (b) Panoramic view taken 11 weeks after surgery.