Adjunctive use of antimicrobial photodynamic therapy in the treatment of medication-related osteonecrosis of the jaws: A case report

Photodiagnosis Photodyn Ther. 2018 Sep;23:99-101. doi: 10.1016/j.pdpdt.2018.06.004. Epub 2018 Jun 6.


Medication-related osteonecrosis of the jaws is a delayed healing condition commonly recognized as a serious adverse effect of antiresorptive therapy and is particularly associated with aminobisphosphonate treatment. In the present report, a 62-year-old osteoporotic female patient treated with intramuscular injections of clodronate for 3 years exhibited clinical signs of exposed necrotic bone and inflamed mucosa 4 months after tooth extractions in the mandibular interforaminal region. The treatment consisted of sequestrectomy, open-flap debridement, and adjunctive use of antimicrobial photodynamic therapy to decontaminate the affected hard and soft tissues. Successful results were obtained and maintained from both clinical and radiological aspects. No recurrence was observed up to 6 months of follow-up.

Keywords: Bisphosphonates; Decontamination; Oral surgery; Osteonecrosis; Photodynamic therapy.

Publication types

  • Case Reports

MeSH terms

  • Bisphosphonate-Associated Osteonecrosis of the Jaw / drug therapy*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery
  • Combined Modality Therapy
  • Debridement / methods
  • Female
  • Humans
  • Methylene Blue / therapeutic use*
  • Middle Aged
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use*


  • Photosensitizing Agents
  • Methylene Blue