PDT applied on medication-associated osteonecrosis or osteoradionecrosis of the jaws

• Grant number: 22/10869-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2022
• End date: October 31, 2023
• Field of knowledge: Health Sciences - Dentistry
• Principal Investigator: Fábio de Abreu Alves
• Grantee: Fernanda das Neves Lopes
• Host Institution: Faculdade de Odontologia (FO). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Introduction. Osteonecrosis involving the gnathic bones is mainly related to the use of antiresorptive drugs and radiotherapy in the head and neck region. This bone alteration is characterized by exposed necrotic bone or intra and/or extraoral fistulas, which can cause intense pain and affects negatively the patient's quality of life. Photodynamic Therapy (PDT) is a therapeutic modality that consists of the combination of a photosensitizer, a light source of adequate wavelength and oxygen. This therapy has shown good results in the treatment of osteonecrosis in reported clinical cases, but more studies on the subject are still lacking. Objective. The present study aims to evaluate the effectiveness of PDT in the management of osteonecrosis of the gnathic bones associated with drugs or radiotherapy. Methodology. Patients treated at the A.C. Camargo Cancer Center who have osteonecrosis associated with medication or radiotherapy will be evaluated and randomized into 2 groups: standard therapy group (0.12% chlorhexidine irrigation and antibiotic therapy, if necessary) or PDT group (0.12% chlorhexidine irrigation, antibiotic therapy, if necessary, and application of PDT, which includes the use of photosensitizer in the bone or fistula, followed by application of low power laser at 4J, 100mW and 40s per point. PDT application, irrigations and clinical evaluations will occur weekly. The expected results after the PDT sessions are evolution in healing, with reduction of bone exposure and suppuration and, mainly, reduction of pain.