Osteonecrosis of the jaw with the use of bisphosphonates and treatment with laser therapy and magnetotherapy: a concise systematic review

Abstract

Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been increasing, mainly as a consequence of the treatment of osteoporosis in elderly women. During bone resorption, bisphosphonates (BP) are taken into osteoclasts and exhibit cytotoxicity, producing a long-lasting anti-bone resorptive effect. several energy-based devices have been used with substantial clinical improvement in the treatment. Devices are widely used in various types of treatment, such as LASER, LED, TEMs, infrared devices, Ultrasound, and radiofrequency, among others. Objective: It was to analyze the main findings and weave approaches of scientific evidence of the occurrence of osteonecrosis by the use of bisphosphonates, as well as the possible treatments, highlighting laser therapy and magnetotherapy. Methods: The present study was followed by a systematic review model (PRISMA). The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias from the included studies. The present study was carried out from December 2022 to March 2023. Results and Conclusion: A total of 138 articles were found. Initially, duplicate articles were excluded. After this process, the abstracts were evaluated and a new exclusion was performed based on the GRADE Instrument and Risk of Bias. A total of 58 articles were fully evaluated and 26 were included and discussed in this study. It was concluded that photobiomodulation therapy and magnetotherapy showed safety and efficacy in the treatment of BRONJ, through the reduction of phlogistic signs, faster healing, and reduction of postoperative morbidity. Only four applications of low-intensity laser and magnetotherapy were enough to reduce the inflammatory process in the surgical wound, stimulate the tissue repair process and provide postoperative analgesia.