| Autor: |
Nica DF; Department of Anaesthesiology and Oral Surgery, School of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300041 Timisoara, Romania., Riviș M; Department of Anaesthesiology and Oral Surgery, School of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300041 Timisoara, Romania., Roi CI; Department of Anaesthesiology and Oral Surgery, School of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300041 Timisoara, Romania., Todea CD; Department of Oral Rehabilitation and Dental Emergencies, School of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 2A Eftimie Murgu Place, 300041 Timisoara, Romania., Duma VF; 3OM Optomechatronics Group, Faculty of Engineering, 'Aurel Vlaicu' University of Arad, 2 Elena Dragoi Str., 310177 Arad, Romania.; Doctoral School, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania.; Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania., Sinescu C; Research Center in Dental Medicine Using Conventional and Alternative Technologies, School of Dental Medicine, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania. |
| Abstrakt: |
Background and Objectives : Antiresorptive or anti-angiogenic agents may induce medication-related osteonecrosis of the jaws (MRONJ), which represents a challenge for clinicians. The aim of this study is to design and apply a composed and stage-approach therapy combining antibiotherapy, surgical treatment, and photo-biomodulation (PBM) for the prevention or treatment of MRONJ lesions. Materials and Methods : The proposed treatment protocol was carried out in the Department of Oral & Maxillofacial Surgery of the "Victor Babes" University of Medicine and Farmacy of Timisoara, in 2018-2020. A total of 241 patients who were previously exposed to antiresorptive or anti-angiogenic therapy, as well as patients already diagnosed with MRONJ at different stages of the disease were treated. A preventive protocol was applied for patients in an "at risk" stage. Patients in more advanced stages received a complex treatment. Results: The healing proved to be complete, with spontaneous bone coverage in all the n = 84 cases placed in an "at risk" stage. For the n = 49 patients belonging to stage 0, pain reductions and decreases of mucosal inflammations were also obtained in all cases. For the n = 108 patients proposed for surgery (i.e., in stages 1, 2, or 3 of MRONJ), a total healing rate of 91.66% was obtained after the first surgery, while considering the downscaling to stage 1 as a treatment "success", only one "failure" was reported. This brings the overall "success" rate to 96.68% for a complete healing, and to 99.59% when downscaling to stage 1 is included in the healing rate. Conclusions: Therefore, the clinical outcome of the present study indicates that patients with MRONJ in almost all stages of the disease can benefit from such a proposed association of methods, with superior clinical results compared to classical therapies. |
