Complementarity of Photo-Biomodulation, Surgical Treatment, and Antibiotherapy for Medication-Related Osteonecrosis of the Jaws (MRONJ)

Overview

Journal Medicina (Kaunas)

Publisher MDPI

Specialty General Medicine

Date 2021 Feb 10

PMID 33562600

Citations 8

Authors

Diana Florina Nica

Mircea Rivis

Ciprian Ioan Roi

Carmen Darinca Todea

Virgil-Florin Duma

Cosmin Sinescu

Affiliations

Soon will be listed here.

Abstract

: Antiresorptive or anti-angiogenic agents may induce medication-related osteonecrosis of the jaws (MRONJ), which represents a challenge for clinicians. The aim of this study is to design and apply a composed and stage-approach therapy combining antibiotherapy, surgical treatment, and photo-biomodulation (PBM) for the prevention or treatment of MRONJ lesions. : The proposed treatment protocol was carried out in the Department of Oral & Maxillofacial Surgery of the "Victor Babes" University of Medicine and Farmacy of Timisoara, in 2018-2020. A total of 241 patients who were previously exposed to antiresorptive or anti-angiogenic therapy, as well as patients already diagnosed with MRONJ at different stages of the disease were treated. A preventive protocol was applied for patients in an "at risk" stage. Patients in more advanced stages received a complex treatment. The healing proved to be complete, with spontaneous bone coverage in all the = 84 cases placed in an "at risk" stage. For the = 49 patients belonging to stage 0, pain reductions and decreases of mucosal inflammations were also obtained in all cases. For the = 108 patients proposed for surgery (i.e., in stages 1, 2, or 3 of MRONJ), a total healing rate of 91.66% was obtained after the first surgery, while considering the downscaling to stage 1 as a treatment "success", only one "failure" was reported. This brings the overall "success" rate to 96.68% for a complete healing, and to 99.59% when downscaling to stage 1 is included in the healing rate. Therefore, the clinical outcome of the present study indicates that patients with MRONJ in almost all stages of the disease can benefit from such a proposed association of methods, with superior clinical results compared to classical therapies.

Citing Articles

Pharmacological Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) with Pentoxifylline and Tocopherol.

Slowik L, Toton E, Nowak A, Wysocka-Slowik A, Okla M, Slebioda Z J Clin Med. 2025; 14(3).

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A Systematic Review of Laser Photobiomodulation Dosimetry and Treatment Protocols in the Management of Medications-Related Osteonecrosis of the Jaws: A Rationalised Consensus for Future Randomised Controlled Clinical Trials.

Hanna R, Miron I, Dalvi S, Arany P, Bensadoun R, Benedicenti S Pharmaceuticals (Basel). 2024; 17(8).

PMID: 39204116 PMC: 11357434. DOI: 10.3390/ph17081011.

How we manage medication-related osteonecrosis of the jaw.

Byrne H, OReilly S, Weadick C, Brady P, Riordain R Eur J Med Res. 2024; 29(1):402.

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Platelet-Rich Fibrin in Oral Surgery and Implantology: A Narrative Review.

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