Photodynamic therapy in the management of osteonecrosis of the jaws

Vol. 11 – Number 43 – 2020 IMPLANTOLOGY NOTEBOOK Case report Page 46-49 Photodynamic therapy in the management of osteonecrosis of the jaws Luciano Henrique Ferreira Lima1 Ana Paula Cota Viana2 Luiz Henrique de Melo Nogueira3 Isabel Zanforlin Freitas4 João Batista de Freitas2 ABSTRACT Biphosphonate-related osteonecrosis of the jaws (BRONJ) is considered an adverse effect associated with medication used mainly in the treatment of breast cancer and bone metastases. Its use can cause persistent and cumulative damage to the bone structure, resulting in a bone with low mechanical resistance. Once the problem is installed, the dentist should use all the recommended therapeutic approaches in his treatment. In this study is presented the case of a patient using bisphosphonates for bone metastasis treatment, in which the extraction was performed and consequently evolved to a maxillary osteonecrosis in this region. A combination treatment of antibiotic use, conservative surgical debridement and photodynamic therapy (PDT) was instituted for the patient, with total success in the remission of signs and symptoms. In the current literature there is no consensus on the adequate treatment for these cases, but photodynamic therapy presented satisfactory results as an adjunctive treatment of BRONJ. The current study aims to show the importance of PDT as an adjuvant tool on the management of the osteonecrosis, besides reporting a case of osteonecrosis of the jaws treated by antibiotics, surgical debridement and PDT. Descriptors: Photochemotherapy, bisphosphonate-related osteonecrosis of the jaw, tooth extraction. 1 Department of Oral Diagnosis – Piracicaba Dental School, State University of Campinas, Piracicaba/SP, Brazil. 2 Dentistry Department – Pontifical Catholic University of Minas Gerais, Belo Horizonte/MG, Brazil. 3 Dentistry Department – Newton Paiva University Center, Belo Horizonte/MG, Brazil. 4 Dentistry Department – Federal University of Minas Gerais, Belo Horizonte/MG, Brazil.