Department of Preventive Dentistry and Public Oral Health, Yonsei University college of dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Department of Preventive Dentistry and Public Oral Health, Yonsei University college of dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102212. doi: 10.1016/j.pdpdt.2021.102212. Epub 2021 Feb 12.
Recurrence of osteonecrosis of the jaw has been reported after surgery. It is therefore necessary to develop a real-time diagnostic method, which can clearly distinguish the surgical margin from unaffected bone.
We analyzed a sequestrum from a patient with medication-related osteonecrosis of the jaw (MRONJ). Quantitative light induced fluorescence (QLF) was applied to the sequestrum.
In this study, QLF demonstrated three types of fluorescence phenomena (Non-red-fluorescence, hyper-red-fluorescence, and hypo-red-fluorescence) on the sequestrum. Histology revealed geographical, microbiological, and immunological differences based on the fluorescence types on QLF. Non-red-fluorescence showed sclerotic and lamellar bone tissue, hyper-red-fluorescence showed an infectious state due to bacterial invasion and osteolysis, and hypo-red-fluorescence indicated predominantly granular tissue with inflammation, and the absence of bone matrix and bacterial colonies. Based on histologic analysis, we speculated that QLF may be a useful real-time diagnostic tool during surgery for MRONJ.
In conclusion, QLF can be useful in distinguishing between lamellar and infected bone, which are visually similar; QLF-guided ONJ surgery, preserving the Non-red-fluorescent areas and removing the hyper- and hypo-red-fluorescent areas of bone may be useful.
颌骨骨坏死（ONJ）手术后有复发的报道。因此，有必要开发一种实时诊断方法，能够清楚地区分手术边缘和未受影响的骨。
我们分析了一位药物相关性颌骨骨坏死（MRONJ）患者的死骨。对死骨进行定量光致荧光（QLF）分析。
在这项研究中，QLF 在死骨上显示出三种荧光现象（非红色荧光、过度红色荧光和低红色荧光）。组织学根据 QLF 上的荧光类型揭示了地理、微生物和免疫学的差异。非红色荧光显示硬化和板层骨组织，过度红色荧光显示由于细菌入侵和骨溶解导致的感染状态，低红色荧光表示主要为炎症的颗粒状组织，缺乏骨基质和细菌菌落。基于组织学分析，我们推测 QLF 可能是 MRONJ 手术中一种有用的实时诊断工具。
总之，QLF 可用于区分肉眼相似的板层骨和感染骨；QLF 引导的 ONJ 手术保留非红色荧光区域并切除过度和低红色荧光的骨区域可能是有用的。
