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Aim <p>The study aims to retrospectively assess and share the experience of the use of photobiomodulation (PBM) as an adjunctive to surgical extraction in patients at-risk for medication-related osteonecrosis of the jaw (MRONJ) due to a treatment history with bone-modifying agents.</p> Methods <p>The department database and medical records were examined in the period between 2016 and 2023. The inclusion criteria were; at-risk patients for MRONJ with current or previous treatment with bone-modifying agents, with or without a history of antiangiogenic agents administration, who underwent single or multiple dental extractions, subjected to PBM preventive protocol, and without a diagnosis or history of MRONJ development. The PBM protocol consisted of four sessions, two sessions before the intervention and two sessions after the intervention. The PBM parameters (per session) were; total power of 0.6&#xa0;W, time of 15&#xa0;min, frequency of 30&#xa0;kHz, and total energy of 577.4&#xa0;J.</p> Results <p>A total of 62 patients (58 females and 4 males) fulfilled the inclusion criteria with a mean age of 67.5 years. Complete healing without the development of MRONJ was shown in 50 (80.65%) patients, and the development of MRONJ was shown in 12 (19.35%) patients. The statistical analysis revealed a higher risk of MRONJ in patients with a history of administration of zoledronic acid (<i>p</i> = 0.029) and in patients undergoing corticosteroid therapy (<i>p</i> = 0.039). While a lower risk was observed in patients in treatment for thyroid pathology (<i>p</i> = 0.055).</p> Conclusions <p>The majority of the included at-risk MRONJ patients showed complete healing after surgical extraction with the use of PBM as an adjunctive modality. Corticosteroid treatment as a systemic risk factor and zoledronic acid as a drug-related risk factor show significant associations with the development of MRONJ.</p>

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Surgical extraction with photobiomodulation as an adjunctive modality in patients at-risk for medication-related osteonecrosis of the jaw: retrospective study

  • 期刊论文

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  • 发表日期：

    2025年4月24日

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  • Gianluca Tenore,
  • Ahmed Mohsen,
  • Alessandro Del Vecchio,
  • Gaspare Palaia,
  • Federica Rocchetti,
  • Lucia Borghetti,
  • Giuseppe Vasile,
  • Francesca Graniero,
  • Umberto Romeo

摘要

Aim

The study aims to retrospectively assess and share the experience of the use of photobiomodulation (PBM) as an adjunctive to surgical extraction in patients at-risk for medication-related osteonecrosis of the jaw (MRONJ) due to a treatment history with bone-modifying agents.

Methods

The department database and medical records were examined in the period between 2016 and 2023. The inclusion criteria were; at-risk patients for MRONJ with current or previous treatment with bone-modifying agents, with or without a history of antiangiogenic agents administration, who underwent single or multiple dental extractions, subjected to PBM preventive protocol, and without a diagnosis or history of MRONJ development. The PBM protocol consisted of four sessions, two sessions before the intervention and two sessions after the intervention. The PBM parameters (per session) were; total power of 0.6 W, time of 15 min, frequency of 30 kHz, and total energy of 577.4 J.

Results

A total of 62 patients (58 females and 4 males) fulfilled the inclusion criteria with a mean age of 67.5 years. Complete healing without the development of MRONJ was shown in 50 (80.65%) patients, and the development of MRONJ was shown in 12 (19.35%) patients. The statistical analysis revealed a higher risk of MRONJ in patients with a history of administration of zoledronic acid (p = 0.029) and in patients undergoing corticosteroid therapy (p = 0.039). While a lower risk was observed in patients in treatment for thyroid pathology (p = 0.055).

Conclusions

The majority of the included at-risk MRONJ patients showed complete healing after surgical extraction with the use of PBM as an adjunctive modality. Corticosteroid treatment as a systemic risk factor and zoledronic acid as a drug-related risk factor show significant associations with the development of MRONJ.