title: Efficacy of laser therapy in the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ): a systematic review.
abstract: Bisphosphonate-related osteonecrosis of the jaw is a well-known potential side effect of long-term bisphosphonate therapy; the primary objective of the treatment should be to improve patient quality of life through pain and infection management, to prevent the development of new lesions, and to slow disease progression. In recent years, the use of laser for bisphosphonate-related osteonecrosis of the jaw has become more widespread, due to its use of administration and widely reported beneficial effects on tissue healing. The present systematic review of the literature sought to elucidate whether low-level laser therapy has positive effects on the treatment of bisphosphonate-related osteonecrosis of the jaw. We conducted a systematic search of the PubMed, EMBASE, and Cochrane Library electronic databases, with no restrictions on language or year of publication. Search strategies were formulated using keywords and Boolean operators. The electronic search strategy retrieved 55 records. From 55 articles, 16 were selected for full-text review, and of these, 10 were ultimately included for data analysis in this review. Our findings show that treatment modalities including laser were associated with superior outcomes in terms of cure or improvement of bisphosphonate-related osteonecrosis of the jaw lesions as compared with conventional surgical and/or conservative drug therapy. It can be concluded that combined treatment with antibiotics, minimally invasive surgery (including Er:YAG laser surgery), and low-level laser therapy in the early stages of the disease should be the gold standard for bisphosphonate-related osteonecrosis of the jaw management.
authors.affiliation: School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681-Building 6, Partenon, Porto Alegre, RS, 90619-900, Brazil. jbbweber@terra.com.br.
authors.forename: João Batista Blessmann
authors.identifier: http://orcid.org/0000-0002-9561-9767
authors.initials: JB
authors.lastname: Weber
authors.affiliation: School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681-Building 6, Partenon, Porto Alegre, RS, 90619-900, Brazil.
authors.forename: Renata Stifelman
authors.initials: RS
authors.lastname: Camilotti
authors.affiliation: School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681-Building 6, Partenon, Porto Alegre, RS, 90619-900, Brazil.
authors.forename: Monique Estér
authors.initials: ME
authors.lastname: Ponte
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000628:therapy*; D003131:Combined Modality Therapy; D000072700:Conservative Treatment; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D028022:Low-Level Light Therapy / Q000379:methods; D011788:Quality of Life
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bisphosphonate-related osteonecrosis of the jaw; Laser therapy; Neoplasm; Neoplasm metastasis; Osteoporosis