Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey.
Department of Pathology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
Eur J Med Res. 2024 Jul 9;29(1):359. doi: 10.1186/s40001-024-01907-3.
Use of numerous medications such as tyrosine kinase inhibitors (sunitinib), monoclonal antibodies (bevacizumab), fusion proteins (aflibercept), mTOR inhibitors (everolimus), radiopharmaceuticals (radium 223), selective estrogen receptor modulators (raloxifene), and immunosuppressants (methotrexate and corticosteroids) has been reported to be a risk factor for development of medication-related osteonecrosis of the jaws till date. This study aimed to evaluate the preventive effect of low-level laser therapy (LLLT) and gaseous ozone on the onset of MRONJ following tooth extraction.
A total of 40 male Wistar rats were randomly allocated into 4 groups of 10 rats each. The groups laser (L), ozone (O), and control (C) received weekly intraperitoneal injections of zoledronic acid (0.06 mg/kg), while group sham (S) received saline solution for 4 weeks. After the 4th injection, all subjects underwent mandibular first molar extraction and adjunctive laser or ozone was applied according to the groups. All the rats were sacrificed at 4 postoperative weeks for comparative histomorphometric evaluation of bone healing in extraction sites.
Laser and ozone groups demonstrated significantly higher bone formation compared to control group (p < 0.05), while no significant difference was found between laser and ozone groups (p = 1.00). Furthermore, the greatest bone formation was observed with the sham group (p < 0.05).
Findings of the current study support that adjunctive LLLT and ozone therapy following tooth extraction may help prevent MRONJ and improve bone healing in subjects under zoledronic acid therapy.
Since the introduction in 2003, great effort has been devoted to developing a certain management protocol for MRONJ. Several publications have appeared in recent years documenting promising results of adjunctive LLLT and ozone application in treatment of MRONJ. However, experimental data are limited on this regard and the present study, for the first time, aimed to evaluate and compare the effects of LLLT and ozone in prevention of MRONJ.
迄今为止，已有报道称，使用多种药物，如酪氨酸激酶抑制剂（舒尼替尼）、单克隆抗体（贝伐单抗）、融合蛋白（阿柏西普）、mTOR 抑制剂（依维莫司）、放射性药物（镭 223）、选择性雌激素受体调节剂（雷洛昔芬）和免疫抑制剂（甲氨蝶呤和皮质类固醇），是导致药物相关性下颌骨坏死发生的一个危险因素。本研究旨在评估低水平激光治疗（LLLT）和气态臭氧对拔牙后 MRONJ 发病的预防作用。
将 40 只雄性 Wistar 大鼠随机分为 4 组，每组 10 只。激光组（L）、臭氧组（O）和对照组（C）每周腹腔内注射唑来膦酸（0.06mg/kg），而假手术组（S）则在 4 周内接受生理盐水注射。第 4 次注射后，所有动物均行下颌第一磨牙拔牙术，并根据分组应用激光或臭氧辅助治疗。所有大鼠在术后 4 周处死，用于比较拔牙部位骨愈合的组织形态计量学评价。
与对照组相比，激光组和臭氧组的骨形成明显更高（p<0.05），而激光组和臭氧组之间无显著差异（p=1.00）。此外，假手术组的骨形成最大（p<0.05）。
本研究结果支持拔牙后辅助 LLLT 和臭氧治疗可能有助于预防 MRONJ，并改善唑来膦酸治疗患者的骨愈合。
自 2003 年引入以来，人们一直在努力制定特定的 MRONJ 管理方案。近年来出现了一些出版物，记录了辅助 LLLT 和臭氧应用治疗 MRONJ 的有希望的结果。然而，在这方面的实验数据有限，本研究首次旨在评估和比较 LLLT 和臭氧在预防 MRONJ 中的作用。
