Fluorescence-guided bone resection in bisphosphonate-associated osteonecrosis of the jaws.
OBJECTIVE
To date, the therapy of bisphosphonate-associated osteonecrosis of the jaws (BONJ) has been hampered by the lack of imaging modalities that enable the extent of necrosis to be visualized. This study aims to demonstrate the feasibility of tetracycline fluorescence guided bone resection in the surgical management of BONJ.


METHODS
Following a 10-day preoperative administration of doxycycline in patients suffering from BONJ, sufficient doxycycline is incorporated into viable bone to be visualized with a certified medical lamp emitting exciting light at 400 to 460 nm.


RESULTS
Viable and necrotic bone can be discriminated intraoperatively in a routine and reproducible manner by doxycycline bone fluorescence.


CONCLUSIONS
In the therapy of BONJ, conservative concepts are to be favored. The fact that necrotic bone can now be selectively resected signifies an improvement of the conservative surgical therapy of BONJ.
Pautke
Christoph
C
Department of Oral and Cranio-Maxillofacial Surgery, Technische Universtität München, Munich, Germany. christoph.pautke@gmx.net
Bauer
Florian
F
Tischer
Thomas
T
Kreutzer
Kilian
K
Weitz
Jochen
J
Kesting
Marco
M
Hölzle
Frank
F
Kolk
Andreas
A
Stürzenbaum
Stephen R
SR
Wolff
Klaus-Dietrich
KD
D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D054893:Cone-Beam Computed Tomography; D004164:Diphosphonates / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005453:Fluorescence; D005470:Fluorometry; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000601:surgery*; D008027:Light; D008297:Male; D019647:Oral Surgical Procedures / Q000379:methods*; D056948:Orthognathic Surgical Procedures; D010020:Osteonecrosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000601:surgery*; D013752:Tetracycline
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D013752:Tetracycline