Laser surgery in management of medication-related osteonecrosis of the jaws: a meta-analysis

Momesso, Gustavo Antônio Corrêa; Lemos, Caa; Santiago, Joel Ferreira; Faverani, Leonardo Pérez; Pellizzer, Eduardo Piza

doi:10.1007/s10006-020-00831-0

Cited by 24 publications

(22 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the number of patients included in these analyses was low. One SR 29 presented “suggestive evidence” in favor of laser surgery in comparison with the use of LLLT associated with conservative treatment. All other meta‐analyses did not present strong evidence in favor of the treatment of MRONJ.…”

Section: Resultsmentioning

confidence: 99%

“…With the exception of LLLT, no alternative therapy has shown efficacy in the treatment of MRONJ. Three systematic reviews 23,27,29 reported that the use of LLLT has a positive effect in the early stages of MRONJ. The use of LLLT stimulates cell metabolism and modulates the inflammatory process, which can improve tissue healing and decrease pain 34 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Weak evidence for the management of medication‐related osteonecrosis of the jaw: An overview of systematic reviews and meta‐analyses

Moraschini

Calasans-Maia

Louro

et al. 2020

J Oral Pathology Medicine

View full text Add to dashboard Cite

Background Although several therapies are proposed for medication‐related osteonecrosis of the jaw (MRONJ), to date there is no consensus or treatment protocol for MRONJ. This overview aims to summarize the available evidence on the management and outcomes of MRONJ. Methods An electronic search without language or date restrictions occurred in five databases and gray literature for articles published until March 2020. This overview was performed according to the PICO format. The eligibility criteria comprised systematic reviews (RS) with or without meta‐analyses that analyzed treatments outcomes for MRONJ. The methodological quality of each SR was evaluated using AMSTAR 2. Results Fifteen studies published between 2014 and 2020 were included in this overview. The summary of the evidence showed that conservative treatment and low level laser therapy can yield favorable results for early stages of MRONJ whereas surgical treatment seems to be better for advanced stages. However, qualitative assessment of the SRs highlighted a global low level of quality. Conclusions There is weak evidence to support treatment protocols for MRONJ. Because of the low quality of the SRs, highlighted by this overview, no insightful therapeutic recommendations can be issued for any intervention for MRONJ.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Weak evidence for the management of medication‐related osteonecrosis of the jaw: An overview of systematic reviews and meta‐analyses

Moraschini

Calasans-Maia

Louro

et al. 2020

J Oral Pathology Medicine

View full text Add to dashboard Cite

show abstract

“…Once established the MRONJ, its staging seems to have influence on treatment success (Ruggiero et al, 2014;Momesso et al, 2020;Coropciuc et al, 2017). The recommendation is that stages 0 and 1 could be treated with non-invasive therapies, like antibiotics, pain killers and mouth rinses.…”

Section: Discussionmentioning

confidence: 99%

“…Although it might be a tendency to manage early staged MRONJ lesions with conservative, non-invasive procedures and advanced lesions with aggressive surgical Research, Society and Development, v. 9, n. 12, e44591211212, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i12.11212 treatments, the decision on what therapy to employ is still controversial (Ruggiero et al, 2014;Blus et al, 2017;Nisi et al, 2016;Momesso, Lemos, Santiago-Júnior, Faverani & Pellizzer, 2020;Coropciuc et al, 2017). Moreover, the efficient management of these complications is always challenging.…”

Section: Introductionmentioning

confidence: 99%

Stage 3 Medication-related osteonecrosis of the jaw (MRONJ): successful conservative treatment with ozone therapy

Lima

Paulo

Silva

et al. 2020

RSD

View full text Add to dashboard Cite

Background: The medication-related osteonecrosis of the jaws is an uncommon severe complication following utilization of certain drugs, but its occurrence has great impact on the patient’s quality of life. Various treatment modalities are used to manage the lesions, including conservative and surgical procedures. Ozone (O3) therapy emerges as an alternative of non-invasive therapy that can benefit the affected patient without surgical risks, due to the potential of stimulate the activation and migration of fibroblasts in an injured area. Case presentation: This article reports the conservative treatment of a maxillary stage 3 medication-related osteonecrosis, in a partial edentulous patient previously treated with intravenous bisphosphonate for multiple myeloma, who had previous cardiac illness. Conclusion: The stage 3 medication-related osteonecrosis was successfully treated with ozone (O3) gas injection and irrigation with ozonated water, with full coverage of the bone and no suppuration or pain at the end of the treatment. No recurrence was seen after twelve months of follow-up.

show abstract

“…Various experimental therapies were proposed for BRONJ treatment, aiming to promote gingival wound healing, as local application of adipose-derived stem cells, of growth factors, of platelet rich fibrine, or low-level laser therapy [10][11][12]. Improved extraction socket healing was achieved by local application of a rescue bisphosphonates treatment able to decrease its bioavailability in the jawbone surfaces [13].…”

Section: Introductionmentioning

confidence: 99%

Calcium Phosphate Ceramics Can Prevent Bisphosphonate-Related Osteonecrosis of the Jaw

et al. 2020

View full text Add to dashboard Cite

Bisphosphonate-associated osteonecrosis of the jaw (BRONJ), a post-surgical non-healing wound condition, is one of the most common side effects in patients treated with nitrogen-containing bisphosphonates. Its physiopathology has been related with suppression of bone turnover, of soft tissue healing and infection. Biphasic calcium phosphates (BCP) are used as a drug delivery vehicle and as a bone substitute in surgical wounds. Due to their capacity to adsorb zoledronate, it was hypothesized these compounds might have a protective effect on the soft tissues in BRONJ wounds. To address this hypothesis, a reproducible in vivo model of BRONJ in Wistar rats was used. This model directly relates chronic bisphosphonate administration with the development of osteonecrosis of the jaw after tooth extraction. BCP granules were placed in the alveolus immediately after tooth extraction in the test group. The animals were evaluated through nuclear medicine, radiology, macroscopic observation, and histologic analysis. Encouragingly, calcium phosphate ceramics were able to limit zoledronate toxicity in vivo and to favor healing, which was evidenced by medical imaging (nuclear medicine and radiology), macroscopically, and through histology. The studied therapeutic option presented itself as a potential solution to prevent the development of maxillary osteonecrosis.

show abstract

Laser surgery in management of medication-related osteonecrosis of the jaws: a meta-analysis

Cited by 24 publications

References 55 publications

Weak evidence for the management of medication‐related osteonecrosis of the jaw: An overview of systematic reviews and meta‐analyses

Weak evidence for the management of medication‐related osteonecrosis of the jaw: An overview of systematic reviews and meta‐analyses

Stage 3 Medication-related osteonecrosis of the jaw (MRONJ): successful conservative treatment with ozone therapy

Calcium Phosphate Ceramics Can Prevent Bisphosphonate-Related Osteonecrosis of the Jaw

Contact Info

Product

Resources

About