CLINICAL EFFECTIVENESS OF PHOTODYNAMIC ANTIMICROBIAL THERAPY IN MRONJ - SYSTEMATIC REVIEW

Abstract

<h3>Objectives</h3> Medication-related osteonecrosis of the jaw (MRONJ) is a persistent avascular bone exposure related to antiresorptive and/or antiangiogenic drugs use. Photodynamic antimicrobial therapy (aPDT) is reported as a promising therapy for MRONJ. This study aimed to systematically review the literature about the use of aPDT in preventing and/or treating MRONJ. <h3>Study Design</h3> Prospective and retrospective cohorts, randomized and nonrandomized trials, and case series enrolling adult patients were considered for inclusion. Study selection and data extracted were analyzed independently by 2 researchers. A search was conducted according to PRISMA guideline on MEDLINE-PubMed, Scopus, Web of Science, and Cochrane Library, including studies up to August 2020, with a total of 904 articles, of which 2 were included in final review according to the inclusion criteria. <h3>Results</h3> Due to the high heterogeneity among the included studies, meta-analysis was not feasible. Diode laser was the light source reported in both studies, and 0.01% methylene blue and its derivative, 0.01% phenothiazine chloride, were the reported photosensitizers. <h3>Conclusions</h3> aPDT was effective for both prevention and treatment of MRONJ. Despite these promising results, further randomized controlled trials are necessary to ensure the effectiveness of isolated use of aPDT in the treatment and/or prevention of MRONJ.