title: Laser GaAlAs (λ860 nm) photobiomodulation for the treatment of bisphosphonate-induced osteonecrosis of the jaw.
abstract: OBJECTIVE
  The aim of this article is to report a case of bisphosphonate-induced osteonecrosis (ONJ-BP) of the jaw treated by curettage of the necrotic bone, low-level laser therapy (LLLT), and antibiotic therapy.
  
  
  BACKGROUND
  ONJ-BP is characterized by painful ulcerations of the oral mucosa, is prone to bone necrosis that does not heal within 8 weeks after diagnosis, and is often difficult to treat. No definitive standard of care has been established for ONJ-BP. LLLT improves wound healing, relieves pain, and appears to be a promising treatment modality for patients with ONJ-BP.
  
  
  METHODS
  An 82-year-old man taking intravenous bisphosphonate presented with ONJ-BP after tooth extraction. The patient was treated by LLLT using a GaAlAs diode laser with the following settings: wavelength, 860 nm; 70 mW; continuous wave; and spot size 4 mm(2). An energy density of 4.2 J/cm(2) per point was applied in a punctual contact manner every 48 h for 10 days, in association with antibiotic therapy and curettage of the necrotic bone. Reduction in painful symptoms was reported after the second irradiation session, and tissue healing was complete at the end of the third week following oral curettage. The patient was followed up for 12 months and exhibited good oral healt and quality of life.
  
  
  CONCLUSIONS
  The therapeutic protocol used in this study had a positive effect on tissue healing and remission of painful symptoms, resulting in better oral health and quality of life for the patient.
authors.affiliation: School of Dentistry, Graduation Program, Federal University of Bahia, Salvador, Bahia, Brazil.
authors.forename: Milena Góes
authors.initials: MG
authors.lastname: da Guarda
authors.forename: Gardênia Matos
authors.initials: GM
authors.lastname: Paraguassú
authors.forename: Naiadja Santana
authors.initials: NS
authors.lastname: Cerqueira
authors.forename: Patrícia Ramos
authors.initials: PR
authors.lastname: Cury
authors.forename: Jener Gonçalves
authors.initials: JG
authors.lastname: Farias
authors.forename: Luciana Maria Pedreira
authors.initials: LM
authors.lastname: Ramalho
mesh_terms: D000369:Aged, 80 and over; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000532:radiotherapy*; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced / Q000532:radiotherapy*; D054023:Lasers, Semiconductor; D028022:Low-Level Light Therapy; D008297:Male