Del Pilar Rodríguez-Sánchez Maria, Statkievicz Cristian, de Mello-Neto João Martins, Toro Luan Felipe, Bassi Ana Paula Farnezzi, Garcia Valdir Gouveia, Theodoro Letícia Helena, Ervolino Edilson
Montería Dental School Univ. del Sinú - UNISINU, Estrada 1w, 38-153, CEP: 4536534, Montería-COR, Colombia.
São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, R. José Bonifácio, 1193, CEP: 16015-050, Araçatuba-SP, Brazil.
J Lasers Med Sci. 2020 Winter;11(1):98-103. doi: 10.15171/jlms.2020.16. Epub 2020 Jan 18.
Bisphosphonates consist of a range of drugs used in the treatment of osteopathy or some osteotropic malignancies. Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse consequence of their use. Conventional treatment is not always effective, so it is necessary to resort to the use of adjuvant therapies. This study aimed to evaluate the effectiveness of the association of surgery, antibiotic therapy and low-level laser (LLL) therapy as a treatment strategy for MRONJ through the presentation of a clinical case. A 49-year-old female patient presented for the diagnosis and treatment of bone lesions in the maxillae. The patient reported that she had used zoledronate for 1 year. Five years later there were 2 painless bone lesions on both sides of the maxilla, following the extraction of the first upper molars. Clinical, tomographic and histopathologic examination established the diagnosis of MRONJ. The treatment consisted of the curettage of the necrotic bone, antibiotic and thirteen LLL therapy sessions. Integral mucosal healing was observed after a two-month follow-up and no symptoms were detected. The patient was evaluated at 6 and 12 postoperative months without complications. The combination of surgery, antibiotic therapy, and LLL therapy has shown to be effective in the treatment of MRONJ.
双膦酸盐类药物包括一系列用于治疗骨病或某些亲骨性恶性肿瘤的药物。药物相关性颌骨坏死（MRONJ）是使用这类药物产生的严重不良后果。传统治疗并非总是有效，因此有必要采用辅助治疗方法。本研究旨在通过一个临床病例展示，评估手术、抗生素治疗和低强度激光（LLL）治疗联合使用作为MRONJ治疗策略的有效性。一名49岁女性患者因上颌骨骨病变前来诊断和治疗。患者报告称她使用唑来膦酸1年。5年后，在拔除上颌第一磨牙后，上颌两侧出现2处无痛性骨病变。临床、断层扫描和组织病理学检查确诊为MRONJ。治疗包括刮除坏死骨、抗生素治疗和13次LLL治疗。两个月的随访后观察到黏膜完全愈合，未检测到任何症状。术后6个月和12个月对患者进行评估，未出现并发症。手术、抗生素治疗和LLL治疗联合使用已证明对MRONJ治疗有效。
