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

J Appl Oral Sci. 2018:26:e20170172. doi: 10.1590/1678-7757-2017-0172. Epub 2018 May 21.

Abstract

Background: Osteoradionecrosis of the jaw (ORNJ) is the most severe and complex sequel of head and neck radiotherapy (RT) because of the bone involved, it may cause pain, paresthesia, foul odor, fistulae with suppuration, need for extra oral communication and pathological fracture. We treated twenty lesions of ORNJ using low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT). The objective of this study was to stimulate the affected area to homeostasis and to promote the healing of the oral mucosa.

Methods: We performed aPDT on the exposed bone, while LLLT was performed around the bone exposure (red spectrum) and on the affected jaw (infrared spectrum). Monitoring and clinical intervention occurred weekly or biweekly for 2 years.

Results: 100% of the sample presented clinical improvement, and 80% presented complete covering of the bone exposure by intact oral mucosa.

Conclusion: LLLT and aPDT showed positive results as an adjuvant therapy to treat ORNJ.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents / therapeutic use*
  • Chemoradiotherapy, Adjuvant / methods*
  • Dose-Response Relationship, Radiation
  • Female
  • Homeostasis / drug effects
  • Homeostasis / radiation effects
  • Humans
  • Jaw Diseases / pathology
  • Jaw Diseases / therapy*
  • Low-Level Light Therapy / methods*
  • Male
  • Middle Aged
  • Mouth Mucosa / drug effects
  • Mouth Mucosa / radiation effects
  • Osteoradionecrosis / pathology
  • Osteoradionecrosis / therapy*
  • Photochemotherapy / methods*
  • Prospective Studies
  • Reproducibility of Results
  • Time Factors
  • Treatment Outcome
  • Wound Healing / radiation effects

Substances

  • Anti-Infective Agents