title: Medication-Related Osteonecrosis of the Jaw: An Autofluorescence-Guided Surgical Approach Performed with Er:YAG Laser.
abstract: OBJECTIVE
  The aim of this study was to propose an autofluorescence (AF)-guided surgical approach performed with Er:YAG laser and Nd:YAG low-level laser therapy (LLLT).
  
  
  BACKGROUND
  Medication-related osteonecrosis of the jaw (MRONJ) therapy remains an unresolved problem. The proposed conservative and surgical treatment regimens are associated with contradictory success rates. However, the increased experience with MRONJ management suggests that surgical therapy can halt disease progression, and can allow a histology-based diagnosis of osteonecrosis. Surgical approach with Er:YAG laser is associated with significantly better results compared with medical treatment and traditional surgical approaches. One of the difficulties encountered during surgical removal of a MRONJ is the precise individuation of necrotic bone margins.
  
  
  METHODS
  A case of Stage III maxillary osteonecrosis treated with a new surgical approach is presented.
  
  
  RESULTS
  After 7 months of follow-up, complete mucosal healing was evident, and the patient was free of symptoms. Such a technique allowed a highly accurate and minimally invasive approach through the selective ablation of the non-/hypofluorescent areas.
  
  
  CONCLUSIONS
  Taking into account the advantages of laser therapy and the possible effectiveness of AF in highlighting surgical margins, this approach would probably achieve excellent outcomes.
authors.affiliation: 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Vescovi
authors.affiliation: 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy .
authors.forename: Ilaria
authors.initials: I
authors.lastname: Giovannacci
authors.affiliation: 2 Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians Universität München , Munich, Germany .
authors.forename: Sven
authors.initials: S
authors.lastname: Otto
authors.affiliation: 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy .
authors.forename: Maddalena
authors.initials: M
authors.lastname: Manfredi
authors.affiliation: 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy .
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Merigo
authors.affiliation: 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy .
authors.forename: Carlo
authors.initials: C
authors.lastname: Fornaini
authors.affiliation: 3 Department of Dental Sciences, Faculty of Medicine, University of Liege , Liege, Belgium .
authors.forename: Samir
authors.initials: S
authors.lastname: Nammour
authors.affiliation: 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy .
authors.forename: Marco
authors.initials: M
authors.lastname: Meleti
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy; D008297:Male; D063166:Maxillary Osteotomy