The Effectiveness of the Low-Level Laser, Antibiotic and Surgical Therapy in the Treatment of Medication-Related Osteonecrosis of the Jaws: A Case Report

Abstract Introduction: Bisphosphonates consist of a range of drugs used in the treatment of osteopathy or some osteotropic malignancies. Medication-related osteonecrosis of the jaws (MRONJ) is a serious adverse consequence from their use. Conventional treatment is not always effective, so it is necessary to resort to the use of adjuvant therapies. This study aimed to evaluate the effectiveness of the association of surgery, antibiotic therapy and low-level laser (LLL) therapy as a treatment strategy for MRONJ through the presentation of a clinical case.Case presentation: A ۴۹-year-old patient, female gender, presented for diagnosis and treatment of bone lesions in the maxillae. The patient reported that she had used zoledronate for one year. Five years later there were two painless bone lesions in both sides of maxilla, following extraction of the first upper molars. Clinical, tomographic and histopathologic examination established the diagnosis of MRONJ. The treatment consisted of curettage of necrotic bone, antibiotics and thirteen LLL therapy sessions. The integral mucosal healing was observed after two months of follow-up and no symptoms were detected. The patient was evaluated at six and ۱۲ postoperative months without complications.Conclusion: The combination of surgery, antibiotic therapy and LLL therapy has shown be effective in the treatment of MRONJ. Keywords: Anti-bacterial agents Diphosphonates Laser therapy Oral surgical procedures Osteonecrosis.