Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy

Ribeiro, Guilherme Henrique; Minamisako, Mariana Comparotto; Rath, Inês Beatriz da Silva; Santos, Aira Maria Bonfim; Simões, Alyne; Pereira, Keila Cristina Rausch; Grando, Liliane Janete

doi:10.1590/1678-7757-2017-0172

Cited by 47 publications

(35 citation statements)

References 29 publications

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“…The only LLLT report found in our review dated back to 2018 ( 24 ). The effectiveness of LLLT is supported by studies in which its effects on the healing process of the oral mucosa are highlighted.…”

Section: Discussionmentioning

confidence: 99%

“…All of these treatments were guided mainly by Marx's theory ( 9 ). More recently and in light of the pathophysiology of the disease proposed by Delanian ( 20 ), pharmacological treatment with pentoxifylline-tocopherol with or without clodronate (PENTOCLO) ( 22 ), teriparatide ( 23 ) and low-level laser therapy (LLLT) ( 24 ) have been introduced.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review

Camolesi

Ortega²,

Medina³

et al. 2021

Med Oral

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Background to systematically review the literature, comparing the healing of osteoradionecrosis (ORN) among the therapeutic alternatives: surgical, pharmacological and combined. Material and Methods The review was organized according to the PRISMA protocol with regards to the following PICO question: patients with ORN of the jaws (P=Patient); all interventions reported (I = intervention); between all therapies (C=Comparison); healing of lesions (O=outcome). Results Surgical treatment was the most common choice (46.3%) followed by pharmacological treatment, exclusively (25.9%) or combined (26.9%). Treatment exclusively by surgical intervention seems to be most effective option, with 51.2% of the lesions healed, OR for healing of 5.7 (CI95% 1.9-16.9, p =0.002). Only 1 case (0.9%) corresponded to low level laser therapy. Conclusions It seems clear that early intervention with conservative surgical combined with pharmacological methods improves the prognosis of ORN. Key words: Osteoradionecrosis, radiotherapy bone necrosis, hyperbaric oxygen, pentoxifylline, teriparatide, low level laser therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review

Camolesi

Ortega²,

Medina³

et al. 2021

Med Oral

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“…A laserterapia, além de poder ser utilizada para acelerar a osseointegração e a cicatrização de tecidos moles, é um excelente aliado contra a peri-implantite, de forma que reduz a microflora bacteriana, com isso, diminui a agressão dos agentes patológicos sobre o periodonto (HESSLING et al, 2015;NOBA et al, 2018). Ribeiro et al (2018), em seu estudo, observou resultados imediatos após as sessões iniciais.…”

Section: Implantes Dentários Em Pacientes Irradiadosunclassified

Dental Implants in Patients Who Underwent Radiotherapy in the Head and Neck: Literature Review

Teixeira¹,

Sousa²,

Silva³

2024

Rev. Uningá

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A reabilitação de pacientes que passaram por tratamento radioterápico em região de cabeça e pescoço ainda é um desafio para a implantodontia.O presente trabalho tem como objetivo discutir a instalação de implantes dentários em pacientes submetidos a tratamento radioterápico na região decabeça e pescoço. Trata-se de um estudo de revisão de literatura, considerando as publicações de artigos originais e de revisão, do ano de 2002 a 2020. A pesquisa constou das seguintes palavras-chave:implants, osteoradionecrosis, neoplasms in oral cavity, hyperbaric oxygen therapy, laser therapy, ozone therapy e dental implants in irradiated bones.Nas bases de dados: PubMed, SciELO e Bireme. Os critérios de inclusão de artigos no estudo foram: abordar sobre neoplasias orais, o tratamento das sequelas quepodem ser geradas e a instalação de implantes em ossos que sofreram irradiação. A análise foi realizada considerando informações específicas de cada artigo relacionadas ao idioma, ano de publicação, tipo de pesquisa e o resultado dos dados, que na maioriados casos mostrou-se positivo à instalação de implantes caso se considerem alguns fatores. Com a mudança nos conceitos de tratamento, o avanço da odontologia ao utilizar o planejamento tridimensional e guias cirúrgicos, a evolução do aprimoramento da superfície do titânio e o cumprimento do tempo mínimo de 12 meses do fim da irradiação, é possível obter-se uma previsibilidade no tratamento protético de pacientes submetidos à radioterapia em região de cabeça e pescoço.

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“…A recent retrospective study showed the combined use of low-power laser (Therapy XT-diode laser at 660 nm and 808 nm, DMC Group) with PDT led to remission of ORN and repair of mucosal damage. 27 However, studies evaluating this treatment modality are limited in the current literature, and its reproducibility remains to be seen.…”

Section: Alternative Treatment Modalitiesmentioning

confidence: 99%

Osteoradionecrosis of the Midface and Mandible: Pathogenesis and Management

et al. 2020

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Radiation therapy is an important and commonly used treatment modality for head and neck cancers. Osteoradionecrosis (ORN) is a potential debilitating complication of treatment, which most commonly affects the mandible. Management strategies are tailored to the severity of disease. Medical management including oral rinses, irrigations, antibiotics, and pharmacological treatments is viable for mild-to-moderate ORN. More severe disease is best addressed with a combination of medical management and surgical intervention aimed at aggressively removing devitalized tissue until bleeding bone is encountered and reconstructing the soft tissue and bone defect. Reconstruction with either regional vascularized flaps or vascularized osteocutaneous free flaps in case of larger full-thickness bone defects (greater than 6 cm) or anterior mandible (medial to mental foramen) is most appropriate. Maxillary ORN complications can present with a wide range of functional problems and facial disfigurement. Life-threatening and time-sensitive problems should be treated first, such as skull base bone coverage or correction of severe ectropion, to avoid blindness from exposure keratopathy. Then, less time-sensitive issues can be addressed next, such as nasal obstruction, velopharyngeal insufficiency, and chronic tearing. It may require a combination of specialists from different disciplines to address various issues that can arise from maxillary ORN.

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Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy

Cited by 47 publications

References 29 publications

Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review

Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review

Dental Implants in Patients Who Underwent Radiotherapy in the Head and Neck: Literature Review

Osteoradionecrosis of the Midface and Mandible: Pathogenesis and Management

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