PHOTOBIOMODULATION AS AN ADJUVANT THERAPEUTIC APPROACH IN THE TREATMENT OF DRUG-INDUCED OSTEONECROSIS OF THE JAWS

Abstract

Drug-induced osteonecrosis of the jaws (RONJM) represents a serious adverse complication, characterized by a degenerative process associated with the use of antiangiogenic and antiresorptive drugs. This condition manifests itself through the presence of an area of exposed bone in the maxillofacial region that persists for more than eight weeks, particularly in patients undergoing prolonged bisphosphonate or denosumab therapies with no history of prior radiotherapy to the craniofacial region. The management of RONJM is highly varied and challenging, depending on clinical assessment, imaging findings, and the patient's general health status. This study aimed to perform an integrative literature review to evaluate the efficacy of photobiomodulation as a complementary therapy in the treatment and/or prevention of this condition. The research was conducted through active searches in the PubMed, ScienceDirect, Embase, Scopus and Web of Science databases, covering the period from 2014 to 2023. A total of 2,324 articles were found, of which 10 were selected for the extraction of relevant data. Photobiomodulation as a complementary therapy in the treatment of RONJ plays a significant and promising role, compared to conventional surgical methods alone, presenting superior results. The combination of antibiotic therapy, antimicrobial photodynamic therapy (PDT), surgical removal of the lesion, and consecutive applications of low-level laser has demonstrated complete tissue repair in the affected regions. Therefore, it is concluded that photobiomodulation as an adjuvant intervention in the treatment and prevention of RONJM is an effective and reliable protocol.