Poorna T Anish, Joshna E K, Alagarsamy Ragavi, Pangarikar Anunay, Quraishi Shaikh Sumayyah Almas
Department of Dentistry, Government Medical College and Hospital, Chandigarh, India.
Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
J Maxillofac Oral Surg. 2024 Aug;23(4):1003-1012. doi: 10.1007/s12663-024-02127-2. Epub 2024 Mar 6.
Photodynamic therapy (PDT) is a minimally invasive treatment modality that has been used clinically for early stage and inoperable cancers. Successful use of this atraumatic therapy in osteoradionecrosis (ORN) and osteonecrosis of the jaws (ONJ) has been documented in the literature. The aim of this review was to systematically evaluate the role of photodynamic therapy in ORN and ONJ.
Two independent reviewers conducted an elaborate search in PubMed, Google Scholar and Cochrane's CENTRAL database for studies published on PDT as stand-alone or adjuvant therapy in ORN/ONJ until June 2022. The present study was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Demographic data, type and stage of necrosis of the jaws, site, PDT protocol, time to heal and follow-up were evaluated. Eighteen articles were included totally based on the inclusion and exclusion criteria for final analysis.
A total of 94 patients were included in the present review out of which 36 were males and 58 were females. Five studies reported the use of PDT as an adjuvant therapy in ORN. Thirteen studies reported successful outcomes with PDT in ONJ. Complete epithelialization was achieved with PDT ± other adjuvants in 86/94 (91.48%) patients. The time taken for regression of the lesion ranged between 4 days and 12 months with PDT in the present study.
The reviewed studies demonstrate the effectiveness of PDT, as an adjuvant therapy, in managing various stages of ORN and ONJ.
光动力疗法（PDT）是一种微创治疗方式，已在临床上用于早期和无法手术的癌症。文献中已记载了这种无创疗法在放射性骨坏死（ORN）和颌骨骨坏死（ONJ）中的成功应用。本综述的目的是系统评估光动力疗法在ORN和ONJ中的作用。
两名独立的评审员在PubMed、谷歌学术和Cochrane中心数据库中进行了详尽搜索，以查找截至2022年6月发表的关于PDT作为ORN/ONJ的单一疗法或辅助疗法的研究。本研究基于系统评价和Meta分析的首选报告项目。评估了人口统计学数据、颌骨坏死的类型和阶段、部位、PDT方案、愈合时间和随访情况。根据纳入和排除标准，共纳入18篇文章进行最终分析。
本综述共纳入94例患者，其中男性36例，女性58例。五项研究报告了在ORN中使用PDT作为辅助疗法。十三项研究报告了PDT在ONJ中的成功结果。在86/94（91.48%）例患者中，PDT联合/不联合其他辅助剂实现了完全上皮化。在本研究中，使用PDT后病变消退所需时间为4天至12个月。
综述研究表明，PDT作为一种辅助疗法，在管理ORN和ONJ的各个阶段均有效。
