title: Comparison of auto-fluorescence and tetracycline fluorescence for guided bone surgery of medication-related osteonecrosis of the jaw: a randomized controlled feasibility study.
abstract: Recent studies have indicated that bone shows auto-fluorescence under an appropriate fluorescence lamp. The aim of this preliminary study was to compare the success rates of the established tetracycline fluorescence-guided bone surgery with auto-fluorescence-guided bone surgery in the treatment of medication-related osteonecrosis of the jaw (MRONJ). Forty patients suffering from MRONJ were referred for surgical treatment and were divided randomly into two groups: auto-fluorescence (n=20) or tetracycline fluorescence (n=20) guided bone surgery. The primary endpoint was treatment success, defined as the absence of exposed bone at 8 weeks after surgery. Secondary outcomes assessed were mucosal integrity, signs of infection, pain, and loss of sensitivity; these were evaluated descriptively at 10 days, 8 weeks, 6 months, and 1 year after surgery. At 8 weeks postoperative, 18/20 patients (90%) in the auto-fluorescence group and 17/20 patients (85%) in the tetracycline fluorescence group showed mucosal integrity (P>0.05). At the last follow-up, 94% in the auto-fluorescence group and 89% in the tetracycline fluorescence group presented complete mucosal coverage with no exposed bone, infection, or pain (P>0.05). There was no significant difference between the two techniques for any of the secondary outcomes (P>0.05). The results of this preliminary study show that auto-fluorescence-guided bone surgery has comparable success rates to the established tetracycline fluorescence-guided bone surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: oliver.ristow@med.uni-heidelberg.de.
authors.forename: O
authors.initials: O
authors.lastname: Ristow
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University Munich, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Otto
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University Munich, Munich, Germany; Medizin & Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Geiß
authors.affiliation: Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Kehl
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Berger
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University Munich, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Troeltzsch
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technical University Munich, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Koerdt
authors.affiliation: Medizin & Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Munich, Germany; Department of Oral and Maxillofacial Surgery, Technical University Munich, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hohlweg-Majert
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Freudlsperger
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University Munich, Munich, Germany; Medizin & Aesthetik, Clinic for Oral and Maxillofacial and Plastic Surgery, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Pautke
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005453:Fluorescence; D006801:Humans; D008297:Male; D013752:Tetracycline; D016896:Treatment Outcome
chemical_list: D013752:Tetracycline
keywords: BRONJ; DRONJ; MRONJ; ONJ; VELscope; auto-fluorescence; bisphosphonate; bone; bone fluorescence; necrosis of the jaw; osteonecrosis; tetracycline; therapy