Laser surgery in management of medication-related osteonecrosis of the jaws: a meta-analysis

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Momesso, Gustavo Antonio Correa [UNESP]
Lemos, Cleidiel Aparecido Araújo [UNESP]
Santiago-Júnior, Joel Ferreira
Faverani, Leonardo Perez [UNESP]
Pellizzer, Eduardo Piza [UNESP]

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Purpose: The aim of this study was to perform a systematic review and meta-analysis to evaluate the efficacy of laser therapy on medication-related osteonecrosis of the jaw (MRONJ) treatment. Methods: This study followed PRISMA standards, and an electronic search was performed on the PubMed/MEDLINE, Scopus, and Cochrane databases. Eighty-nine articles were found. After reading the manuscripts, 15 articles remained for the review. Three of them were selected for meta-analysis. Results: Female gender was predominant (72.5%), and mean age was 66.5 years. Follow-up varied between 3 and 80 months, and the most used bisphosphonate was zoledronic acid (71.6%). Stage II of MRONJ was the most prevalent (68.9%), and the mandible was the most affected site (64.5%). Qualitative data showed that treatment with laser surgery (Er:YAG) was most effective regarding complete healing of the lesion (90%) compared with other treatments. Meta-analysis data showed that low-level laser therapy (LLLT) was more effective than medical treatment (P = 0.006), and surgical treatment was more effective than LLLT (P = 0.008). Conclusion: Laser surgery was significantly superior to LLLT (p < 0.00001). Therefore, laser surgical therapy seems to be a great management strategy for MRONJ treatment from stage II. LLLT was shown to improve conservative management in earlier MRONJ stages.



Bisphosphonate, Laser therapy, Low-level laser therapy, Medication-associated osteonecrosis of the jaw

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Oral and Maxillofacial Surgery, v. 24, n. 2, p. 133-144, 2020.