Our findings suggest that laser irradiation after tooth extraction can promote osteoblast differentiation, as demonstrated by the higher expression of OCN. Thus, laser irradiation could be considered a way to improve socket healing in conditions at risk for MRONJ development.
Background The exact pathogenesis of medication-related osteonecrosis of the jaw (MRONJ) is still unknown. The aim of this paper was to investigate the effects of zoledronic acid and dexamethasone on the early phases of socket healing in rats subjected to tooth extractions. Material and Methods Thirty male Sprague-Dawley rats were divided into 2 groups: pharmacologically treated group (T, n=20) and non-pharmacologically treated group (C, n=10). T group rats received 0.1 mg/Kg of zoledronic acid (ZOL) and 1 mg/Kg of dexamethasone (DEX) three times a week for 10 consecutive weeks. C group rats were infused with vehicle. After 9 weeks from the first infusion, first maxillary molars were extracted in each of the rats. Quantitative macroscopic and microscopic analysis was performed to evaluate socket healing 8 days after extraction. Results Pharmacologically treated rats showed significant inhibition of bone remodeling. Connective tissue/alveolar bone ratio, osteoclast number and woven bone deposition were significantly reduced in group T compared to group C. Conversely, the proportion of necrotic bone was higher in group T compared to group C (0.8% and 0.3%, respectively. P =0.031). ZOL plus DEX do not cause gross effects on socket healing at a macroscopic level. Conclusions Our findings confirmed that exposure to ZOL plus DEX impairs alveolar wound repair. Inhibition of osteoclastic resorption of socket walls after tooth extraction and the inability to dispose of the necrotic bone may be considered the initial steps of MRONJ onset. Key words: Medication-related osteonecrosis of the jaw, zoledronic acid, dexamethasone, tooth extraction, rat.
Human papillomavirus (HPV) family comprises approximately 150 known subtypes of viruses that can infect humans and other animals. Among these, HPV-16 has been shown to be associated with oral squamous cell carcinoma, particularly within the oropharynx. Here we describe the case of a patient with recurrent p-16 positive papillomatous lesions, which were successfully treated via a diode laser (445 nm) surgery. Radical treatment of HPV-related lesions can be difficult to achieve. Notably, some viruses may infect multiple oral sites and spread throughout the whole mucosa. Even after the supposed radical intervention, HPV particle remnants may lead to recurrences and new lesions. A new laser approach allows radical surgery to be performed, providing an effective method for the treatment of widespread lesions, similar to those reported here. Objective: To report a recurrent p-16 positive oral papillomatous lesion treated with a diode laser. Case report: A 26-year-old man with multiple p-16 positive oral papillomatous lesions was referred for recurrences after treatment with conventional surgery (cold knife). The lesions were successfully treated via diode laser (445 nm) surgery with no recurrence observed during the 6-month follow up. Histological examination showed immunohistochemical positivity for p16.Conclusions: Radical surgical treatment of HPV-related lesions is important to prevent recurrence and malignant transformation. Laser surgery represents an innovative treatment option.
IntroductionThe effect of low level laser therapy (LLLT) on the healing process could be useful for the prevention of post-extractive Bisphosphonate-related Osteonecrosis of the Jaws (BRONJ).The aim of the study was to investigate the effect of LLLT on the post-extractive socket healing in rats treated with zoledronic acid and dexamethasone. Material and MethodsThirty male Sprague-Dawley rats were divided in 4 groups: control group (C, n = 5), laser group (L, n = 5), treatment group (T, n = 10) and treatment plus laser group (T+L, n = 10). Rats of group T and T+L received zoledronate 0,1 mg/Kg and dexamethasone 1 mg/Kg every 2 days for 10 weeks. Rats of group C and L were infused with vehicle.After 9 weeks the first maxillary molars were extracted in all rats. Rats of groups L and T+L received laser therapy (Nd:YAG, 1064 nm, 1.25W, 15Hz, 5 min, 14.37 J/cm2) in the socket area at days 0, 2, 4 and 6 after surgery. At 8 days from extraction, the sockets were clinically assessed with a grading score and the wound area was measured with a dedicate software. Histomorphometric evaluation and western blot analysis of osteopontin and osteocalcin expression were performed. ResultsGroup T+L showed a trend toward a better clinical grading score compared to group T (grade I 22% Vs 28 % -grade II 56% Vs 28% -grade III 22% Vs 44%, respectively). The average wound area was similar among the groups. Inhibition of osteoclastic alveolar bone resorption was found in groups T and T+L (P<0.001). Rats of groups L and T+L showed a significant higher expression of osteocalcin compared to rats of groups C and T (C=0.3993; L=1.394; T=0.2922; T+L=1.156; P=0.0001). The expression of osteopontin did not show significant differences in the groups treated with Nd:YAG compared to the ones that did not receive laser irradiation. High-end Medicine Based on Laser and Biotechnologies, edited by Darinca Carmen Todea, Adrian Gh. Podoleanu, Virgil-Florin Duma, Proc. of SPIE Vol. 9670, 96700H © 2016 SPIE · CCC code: 1605-7422/16/$18 · doi: 10.1117/12.2191847 Proc. of SPIE Vol. 9670 96700H-1 Downloaded From: http://proceedings.spiedigitallibrary.org/ on 06/25/2016 Terms of Use: http://spiedigitallibrary.org/ss/TermsOfUse.aspx ConclusionOur findings suggest that laser irradiation after tooth extraction can promote osteoblast differentiation, as demonstrated by the higher expression of osteocalcin. Thus, laser irradiation could be considered a way to improve socket healing in conditions at risk for MRONJ development
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