## 3 Results and Discussion
### Treatment  
It is assumed that conservative treatment and minor surgical procedures can be performed in outpatient mode [2]. A special case of MRONJ in the vicinity of dental implants is highlighted as an indication for a surgical procedure that can be performed with local anesthesia [28]. The treatment of the aforementioned peri-implant MRONJ consists of implant removal, sequestrectomy, and soft tissue cleanup which leads to a complete recovery in 87% of patients (100% if MRONJ occurred only in the maxillary area) [28, 29]. Nevertheless, patients at a stage so advanced that they require both the resection surgery and later reconstructive procedures need to be referred to a hospital ward [2]. Some authors indicate that the treatment of MRONJ stage III using extensive resectional procedures in conjunction with microvascular flap reconstruction has shown very positive results [30, 31, 32, 33, 34, 35]. The invasive approach with microvascular flap reconstruction has been proven to be successful, with the mucous membrane healing index reaching 97%, however, the possibility of performing free flap surgery depends on the general condition of the patient [36, 37]. However, it should be taken into consideration that such extensive surgical procedures can be followed by serious possible complications. [PERSON] et al. point out that as many as 25% of all patients who underwent such procedures suffered from difficulty in postoperative wound healing [38]. Authors who favor the invasive surgical treatment with microvascular flap reconstruction employ both the soft-tissue (anteriorlateral thigh flap and the radial forearm flap) [38] as well as bone-component flaps (deep circumflexing iliac artery flap, fibular free flap, and scapular free flap) [39, 40]. Those authors, however, do not indicate in what types of clinical situations each flap should be used. They also do not specify what the different success rates are between cases concerning soft-tissue only and those that apply to both soft and hard tissue defects [41]. [PERSON] et al. have introduced an autogenic leukocyte- and platelet-rich fibrin L-PRF that has been widely used in regenerative dentistry [42]. According to the literature, when used for wound closure after surgical procedures in MRONJ patients, it shows good results, especially in conjunction with bone morphogenetic protein 2 (BMP-2) [43]. This is an autogenous material that releases growth factors in extensive time periods and at the same time accelerates the healing processes in soft tissue as well as in the bone [10, 43]. Moreover, it supports hemostasis and reduces postoperative swelling and pain [43]. Fibrin concentrate stimulates the activation of mesenchymal stem cells, which drastically intensifies angiogenesis and tissue regeneration [43]. Some scientists observe a very high effectiveness of this therapy even in individuals that have been treated with intravenous bisphosphonates [44, 45]. Controlled studies of leukocyte-platelet rich fibrin (LPRF) have shown 60-100% success rates [36, 44]. However, a systematic review of studies on the use of autologous platelet concentrates did not give unequivocal results on the effectiveness of this type of therapy [45]. Thus, [PERSON] et al. believe that there is currently insufficient evidence for the effectiveness of the use of platelet concentrates in the prevention and treatment of MRONJ, although they do not exclude that further studies will show such effectiveness [45]. Fluorescence-guided surgery can be helpful in determining resection margins; however, it has not been shown to improve the quality of life of patients who have had it used in place of conventional surgical techniques. [46]. Some of the proposed MRONJ prophylaxis and therapy methods are still in the research phase. The role of hyperbaric oxygen therapy is still unclear but some benefitscoming from implementation of this treatment have been described in patients that did not respond to standard procedures [47].