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Poorna TA, Joshna EK, Alagarsamy R, Pangarikar A, Quraishi SSA. Role of Photodynamic Therapy in Osteonecrosis and Osteoradionecrosis of the Jaws: A Systematic Review. J Maxillofac Oral Surg 2024; 23:1003-1012. [PMID: 39118917 PMCID: PMC11303356 DOI: 10.1007/s12663-024-02127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/24/2024] [Indexed: 08/10/2024] Open
Abstract
Aim 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. Methods 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. Results 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. Conclusion The reviewed studies demonstrate the effectiveness of PDT, as an adjuvant therapy, in managing various stages of ORN and ONJ.
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Affiliation(s)
- T. Anish Poorna
- Department of Dentistry, Government Medical College and Hospital, Chandigarh, India
| | - E. K. Joshna
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
| | - Anunay Pangarikar
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Kalaburagi, Karnataka India
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Çolak S, Erdil A, Gevrek F. Effects of systemic Anatolian propolis administration on a rat-irradiated osteoradionecrosis model. J Appl Oral Sci 2023; 31:e20230231. [PMID: 37909529 PMCID: PMC10609641 DOI: 10.1590/1678-7757-2023-0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/07/2023] [Accepted: 09/12/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE Radiotherapy after head and neck cancer is associated with the risk of osteonecrosis development. This study aims to investigate the effectiveness of systemic propolis application to prevent the disease as it has no definite treatment protocol despite the proposed treatment methods and significantly decreases individuals' quality of life. METHODOLOGY In total, 29 male Wistar-Albino rats were divided into control, 35 Gy irradiation (Group 1), 35 Gy irradiation+100 mg/kg/ml propolis administration (Group 2), and 35 Gy irradiation+200 mg/kg/ml propolis administration groups (Group 3). Propolis was first applied on the day after radiotherapy, except for the control group. Right first and second molars were extracted from all rats three weeks following radiotherapy. Samples were collected seven weeks after radiotherapy. Osteoblast and osteoclast counts were calculated by histomorphometric analysis. Immunohistochemical analysis determined bone morphogenic protein-2 (BMP-2) and transforming growth factor beta-3 (TGFβ-3). RESULTS Group comparison found non-significant differences regarding osteoblast (p=0.130) and osteoclast (p=0.063) counts. However, Group 1 showed the lowest mean osteoblast (OBL: 82.63 [±13.10]) and highest mean osteoclast counts (OCL: 12.63 [±5.55]). OBL/OCL ratio showed significant differences between groups (p=0.011). Despite the significant difference between the Control and Groups 1 (p=0.006) and 2 (p=0.029), Group 3 showed a non-significant difference (p=0.091). For BMP-2 and TGFB3, the control group showed significant differences with the other two groups (p<0.001), except for Group 3. CONCLUSION Anatolian propolis showed beneficial effects in a radiotherapy-mediated osteonecrosis model, highlighting its potential as a promising intervention.
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Affiliation(s)
- Sefa Çolak
- Tokat Gaziosmanpaşa University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Tokat, Turkey
| | - Aras Erdil
- Uşak University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Uşak, Turkey
| | - Fikret Gevrek
- Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Histology and Embryology, Tokat, Turkey
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Pacheco JA, Tholt B, Veiga EV, Pretel H. aPDT associated with sequestrectomy in the treatment of osteonecrosis in cancer patients with metastasis: Case report. Int J Surg Case Rep 2022; 98:107487. [PMID: 35964369 PMCID: PMC9386628 DOI: 10.1016/j.ijscr.2022.107487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/01/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Juliano Abreu Pacheco
- Ribeirão Preto Cancer Hospital, R. Otávio Martins Braga, 50, Res. Florida, Ribeirão Preto, SP, Brazil.
| | - Beatriz Tholt
- Veiga of Almeida University, R. Ibituruna, 108, Maracanã, Rio de Janeiro, RJ, Brazil.
| | - Eugênia Velludo Veiga
- Ribeirão Preto School of Nursing, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Hermes Pretel
- Ribeirão Preto Cancer Hospital, R. Otávio Martins Braga, 50, Res. Florida, Ribeirão Preto, SP, Brazil; Department of Restorative Dentistry, School of Dentistry, São Paulo State University, UNESP, R. Humaitá 1680, Centro, Araraquara, SP, Brazil.
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Moskvin SV, Strazhev SV. [Low-level laser therapy in oncology - what's new? Analysis of 2018-2021 publications]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2022; 99:56-66. [PMID: 36538405 DOI: 10.17116/kurort20229906156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Low-level laser therapy (LLLT) is included in the Federal project «Fight against oncological diseases», which provides for equipping all specialized medical institutions in Russia with the appropriate devices until 2026. PURPOSE OF THE STUDY Publications analysis on the use of LLLT in oncology. MATERIAL AND METHODS To search for publications, databases and libraries were used: PubMed, Scopus, ResearchGate, Google Scholar, J-STAGE, eLibrary.ru for the period 2018-2021. For analysis, publications were selected that are of interest from the point of view of improving the methodology of LLLT, the prospects for the development of this method in the prevention, treatment and rehabilitation of patients. A total of 223 publications were found, including 39 reviews and meta-analyses, mostly in English (165) and Portuguese (41). RESULTS AND DISCUSSION The inclusion of LLLT in the ISOO/MASCC/ASCO recommendations for the treatment of complications such as mucositis, salivary gland hypofunction and xerostomia caused by non-surgical methods of treating cancer patients should be considered as a promising trend. An extremely low level of quality of LLLT techniques was noted, most often the replacement with meaningless «doses», «fluences» instead of the necessary parameters: wavelength, operating mode, power, frequency, exposure, etc. The use of only local illumination instead of systemic methods of LLLT does not allow obtaining the best results of treatment and prevention. Eliminating the shortcomings of treatment protocols with a focus on Russian experience, when laser blood illumination (intravenously or externally) and laser acupuncture are also necessarily carried out with local illumination of the lesion, will bring the effectiveness of LLLT to a qualitatively new, higher level.
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Affiliation(s)
- S V Moskvin
- Academy of Postgraduate Education of Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russia
| | - S V Strazhev
- City Polyclinic No.212 of the Department of Health of the City of Moscow - Branch No. 70, Moscow, Russia
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Antimicrobial photodynamic and photobiomodulation adjuvant therapies for the treatment of perianal abscess. Photodiagnosis Photodyn Ther 2021; 35:102437. [PMID: 34260992 DOI: 10.1016/j.pdpdt.2021.102437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/06/2021] [Indexed: 11/20/2022]
Abstract
Although the treatment and management options for perianal abscess vary considerably, most cases require incision and drainage. Whatever the clinical approach selected, it is imperative to monitor patients to identify postoperative signs and symptoms which suggest treatment failure or further complications, such as sepsis, recurrent abscess, and fistula formation. Considering the debate on the role of postoperative antibiotic therapy for patients with perianal abscess and the significant discomfort caused by the infection, the present study aimed to report a clinical case in which antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) were used after incision and drainage of a simple perianal abscess. Within 5 days, there was no sign or symptom of both infection and inflammation, and after 3 months, no fistulous pathways or perianal collections were present. According to the current case report, the combination of aPDT and PBMT following incision and drainage of perianal abscess may be a smart strategy for infection resolution and prevention of late complications.
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Campos L, Martins F, Tateno RY, Sendyk WR, Palma LF. Antimicrobial photodynamic therapy using optical fiber for oral fistula resulting from mandibular osteoradionecrosis. Photodiagnosis Photodyn Ther 2021; 34:102247. [PMID: 33711533 DOI: 10.1016/j.pdpdt.2021.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
Osteoradionecrosis (ORN) is considered one of the most severe complications of radiotherapy (RT). Treatment modalities for ORN may vary considerably, including conservative or surgical procedures. Recently, alternative managements such as the combination of photobiomodulation therapy (PBMT) and antimicrobial photodynamic therapy (aPDT) have also yielded promising results in patients presenting ORN or delayed healing post-RT. Herein, it is reported a case of ORN manifested as an oral fistula on the mandibular alveolar mucosa in which a combination of PBMT and aPDT was used every 15 days for six weeks. A laser device with an optical fiber was introduced into the fistula for light delivery. Seven days after the first laser session, it was noted complete resolution of both edema and erythema; after six weeks, the ORN fistula was no longer present. According to the current case, the combination of PBMT and aPDT with an optical fiber to deliver the laser light seems to be a suitable alternative for restricted areas such as fistula paths.
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Affiliation(s)
- Luana Campos
- Department of Post-Graduation in Implantology, School of Dentistry, University of Santo Amaro, São Paulo, SP, Brazil; Oral Medicine, Brazilian Institute of Cancer Control, São Paulo, SP, Brazil.
| | - Fabiana Martins
- Department of Post-Graduation in Implantology, School of Dentistry, University of Santo Amaro, São Paulo, SP, Brazil
| | - Ricardo Yudi Tateno
- Department of Post-Graduation in Implantology, School of Dentistry, University of Santo Amaro, São Paulo, SP, Brazil
| | - Wilson Roberto Sendyk
- Department of Post-Graduation in Implantology, School of Dentistry, University of Santo Amaro, São Paulo, SP, Brazil
| | - Luiz Felipe Palma
- Graduate Dentistry Program, Ibirapuera University, São Paulo, SP, Brazil
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Magalhães IA, Forte CPF, Viana TSA, Teófilo CR, Lima Verde RDMB, Magalhães DP, Praxedes Neto RADL, Lima RA, Dantas TS. Photobiomodulation and antimicrobial photodynamic therapy as adjunct in the treatment and prevention of osteoradionecrosis of the jaws: A case report. Photodiagnosis Photodyn Ther 2020; 31:101959. [PMID: 32818642 DOI: 10.1016/j.pdpdt.2020.101959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/21/2020] [Accepted: 08/10/2020] [Indexed: 01/22/2023]
Abstract
CASE REPORT We report on a patient with a history of radiotherapy to the head and neck region exhibiting necrotic bone exposure associated with fistula and purulent exudation in the mandible, with the diagnosis of stage 3 osteoradionecrosis, in addition to a periapical cyst in the maxillary anterior region and multiple root remnants. An antibiotic coverage protocol with amoxicillin and metronidazole was prescribed for subsequent necrotic bone removal. The surgical procedure was performed along with the aPDT using methylene blue and red light, followed by coaptation of the edges of the surgical wound and the healing protocol with LLLT. The extraction of non-rehabilitated teeth was performed two per session using antibiotic coverage, aPDT, and LLLT and mouthwash with 0.12 % chlorhexidine was prescribed until the complete closure of the surgical wound was achieved. Additionally, two aPDT sessions and four LLLT protocols were performed for complete healing of the surgical sites. Extra and intraoral examinations and panoramic and periapical radiographs were performed. No emergence or recurrence of osteonecrosis was observed after 12 months of follow-up.
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