Kim Y, Jung HI, Kim YK, Ku JK. Histologic analysis of osteonecrosis of the jaw according to the different aspects on quantitative light-induced fluorescence images.
Photodiagnosis Photodyn Ther 2021;
34:102212. [PMID:
33588059 DOI:
10.1016/j.pdpdt.2021.102212]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND
Recurrence of osteonecrosis of the jaw has been reported after surgery. It is therefore necessary to develop a real-time diagnostic method, which can clearly distinguish the surgical margin from unaffected bone.
METHODS
We analyzed a sequestrum from a patient with medication-related osteonecrosis of the jaw (MRONJ). Quantitative light induced fluorescence (QLF) was applied to the sequestrum.
RESULTS
In this study, QLF demonstrated three types of fluorescence phenomena (Non-red-fluorescence, hyper-red-fluorescence, and hypo-red-fluorescence) on the sequestrum. Histology revealed geographical, microbiological, and immunological differences based on the fluorescence types on QLF. Non-red-fluorescence showed sclerotic and lamellar bone tissue, hyper-red-fluorescence showed an infectious state due to bacterial invasion and osteolysis, and hypo-red-fluorescence indicated predominantly granular tissue with inflammation, and the absence of bone matrix and bacterial colonies. Based on histologic analysis, we speculated that QLF may be a useful real-time diagnostic tool during surgery for MRONJ.
CONCLUSIONS
In conclusion, QLF can be useful in distinguishing between lamellar and infected bone, which are visually similar; QLF-guided ONJ surgery, preserving the Non-red-fluorescent areas and removing the hyper- and hypo-red-fluorescent areas of bone may be useful.
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