Department of Post-Graduation in Implantology, School of Dentistry, University of Santo Amaro, São Paulo, SP, Brazil; Oral Medicine, Brazilian Institute of Cancer Control, São Paulo, SP, Brazil.
Department of Post-Graduation in Implantology, School of Dentistry, University of Santo Amaro, São Paulo, SP, Brazil.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102247. doi: 10.1016/j.pdpdt.2021.102247. Epub 2021 Mar 9.
Osteoradionecrosis (ORN) is considered one of the most severe complications of radiotherapy (RT). Treatment modalities for ORN may vary considerably, including conservative or surgical procedures. Recently, alternative managements such as the combination of photobiomodulation therapy (PBMT) and antimicrobial photodynamic therapy (aPDT) have also yielded promising results in patients presenting ORN or delayed healing post-RT. Herein, it is reported a case of ORN manifested as an oral fistula on the mandibular alveolar mucosa in which a combination of PBMT and aPDT was used every 15 days for six weeks. A laser device with an optical fiber was introduced into the fistula for light delivery. Seven days after the first laser session, it was noted complete resolution of both edema and erythema; after six weeks, the ORN fistula was no longer present. According to the current case, the combination of PBMT and aPDT with an optical fiber to deliver the laser light seems to be a suitable alternative for restricted areas such as fistula paths.
放射性骨坏死（ORN）被认为是放射治疗（RT）最严重的并发症之一。ORN 的治疗方式可能有很大差异，包括保守或手术治疗。最近，一些替代治疗方法，如光生物调节疗法（PBMT）和抗菌光动力疗法（aPDT）的联合应用，在 ORN 或 RT 后延迟愈合的患者中也取得了有前景的结果。本文报告了一例 ORN 病例，表现为下颌牙槽黏膜的口腔瘘，采用 PBMT 和 aPDT 联合治疗，每 15 天治疗一次，共治疗 6 周。将光纤激光设备引入瘘管进行光照。第一次激光治疗后 7 天，水肿和红斑完全消退；6 周后，ORN 瘘管不再存在。根据目前的病例，光纤输送激光的 PBMT 和 aPDT 联合治疗似乎是瘘管等受限区域的一种合适选择。
