Caroline Ballardin1, Cecilia Luiz Pereira-Stabile2, Glaykon Alex Vitti Stabile3,4. 1. Oral and Maxillofacial Surgery Residency, State University of Londrina, Londrina, Brazil. 2. Oral and Maxillofacial Surgery, State University of Londrina, Londrina, Brazil. 3. Oral and Maxillofacial Surgery Residency, State University of Londrina, Londrina, Brazil. glaykon.bmf@gmail.com. 4. Department of Oral Medicine and Pediatric Dentistry, State University of Londrina, Rodovia Celso Garcia Cid, PR 445 Km 380, Campus Universitário, Londrina, PR, CEP 86.057-970, Brazil. glaykon.bmf@gmail.com.
Abstract
PURPOSE: Fluorescence-guided surgery has been recommended for the diagnosis of bone margins in cases of mandibular osteonecrosis. In this article, we report a case in which a generic violet light was used in order to activate bone fluorescence after the administration of tetracycline derivatives, as an alternative to a specific, more expensive equipment that is commercially available for this purpose. The patient had been using alendronate for osteoporosis, resulting in medication-related osteonecrosis of the jaws. METHODS: The treatment protocol includes preoperative administration of doxycycline and the application of a generic violet light during surgery in order to observe the fluorescence of bone in response to excitation through the light emitted by this device. RESULTS: With an effective visualization of the limit between healthy and devitalized bone tissue, it was possible to perform the necrotic tissue removal. The lesion regressed from stage 2 to stage 0, with no clinical or radiographic evidence of necrotic bone. CONCLUSIONS: These results suggest the feasibility of using a generic violet light source as a low-cost alternative for fluorescence-guided surgery.
PURPOSE: Fluorescence-guided surgery has been recommended for the diagnosis of bone margins in cases of mandibular osteonecrosis. In this article, we report a case in which a generic violet light was used in order to activate bone fluorescence after the administration of tetracycline derivatives, as an alternative to a specific, more expensive equipment that is commercially available for this purpose. The patient had been using alendronate for osteoporosis, resulting in medication-related osteonecrosis of the jaws. METHODS: The treatment protocol includes preoperative administration of doxycycline and the application of a generic violet light during surgery in order to observe the fluorescence of bone in response to excitation through the light emitted by this device. RESULTS: With an effective visualization of the limit between healthy and devitalized bone tissue, it was possible to perform the necrotic tissue removal. The lesion regressed from stage 2 to stage 0, with no clinical or radiographic evidence of necrotic bone. CONCLUSIONS: These results suggest the feasibility of using a generic violet light source as a low-cost alternative for fluorescence-guided surgery.
Entities:
Keywords:
Bisphosphonates; Fluorescence; MRONJ; Osteonecrosis of the jaw
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