Background:Osteoradionecrosis of the jaw (ORNJ) is the most severe and complex sequel of head and neck radiotherapy (RT) because of the bone involved, it may cause pain, paresthesia, foul odor, fistulae with suppuration, need for extra oral communication and pathological fracture. We treated twenty lesions of ORNJ using low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT). The objective of this study was to stimulate the affected area to homeostasis and to promote the healing of the oral mucosa.Methods:We performed aPDT on the exposed bone, while LLLT was performed around the bone exposure (red spectrum) and on the affected jaw (infrared spectrum). Monitoring and clinical intervention occurred weekly or biweekly for 2 years.Results:100% of the sample presented clinical improvement, and 80% presented complete covering of the bone exposure by intact oral mucosa.Conclusion:LLLT and aPDT showed positive results as an adjuvant therapy to treat ORNJ.

Medication-related osteonecrosis of the jaws (MRONJ) can be considered an inability of the alveolar bone to respond to an injury, which frequently leads to severe local and systemic complications. Once the problem is installed, dentist must use all therapeutic approaches recommended. This manuscript reports a successful management of MRONJ handled with antibiotics, conservative debridement, low-level laser therapy (LLLT), and photodynamic therapy (PDT) up to 12 months. As healing of MRONJ may be very slow, combined therapeutic approaches are required. Besides the recommended conventional treatment protocol, LLLT and PDT are important tools to contribute to healing and improvement of patient's quality of life.

Objectives: Determine the prevalence of radiographic findings (RF) on both jaws among patients receiving antiresorptive bone therapy. methods: Six electronic databases and partial grey literature were searched. Data was collected based on predetermined criteria. The key features from the included studies were extracted. The MAStARI tool assessed the potential risk of bias (RoB) among the studies, while the GRADE approach determined the level of evidence. Results: 29 studies were identified and included in the qualitative analysis, totalling 1133 patients. 27 studies had sufficient data to be included in a series of meta-analysis reporting 12 types of radiographic findings, and were split in two groups based on their study design. G1 comprised descriptive observational studies and G2 analytical cross-sectional studies. Two studies presented a high RoB, 16 had a moderate RoB, and 11 had low RoB. The overall level of evidence identified was very low. The most frequent RF were mixed lytic-sclerotic areas (73.88%), followed by osteolytic changes (66.18%), osteosclerosis (65.75%), cortical bone erosion (50.83%), persisting alveolar socket (45.77%), periodontal ligament (PDL) widening (44.69%), and inferior alveolar canal (IAC) involvement (43.40%). Less frequent, but equally important, were the periosteal reaction (34.27%), lamina dura thickening (32.97%), sequestrum (29.94%), pathologic fracture (20.90%), and density confluence of cortical and cancellous bone (16.61%). 20 patients reported no signs. conclusions: RF prevalence was high and mainly included mixed lytic-sclerotic areas, osteolysis, osteosclerosis, cortical bone erosion, persisting alveolar socket, PDL-widening, IAC-involvement. Due to the very low level of evidence (GRADE) caution should be exercised when considering these findings.

This study investigated the effect of radiation timing on the bond strength of resin cement to intraradicular dentine. Fifty human teeth were distributed into 5 groups (n = 10): Control (nonirradiated teeth), Before‐RCT (teeth irradiated before root canal treatment), After‐CH (teeth irradiated after canal preparation and placement of calcium hydroxide intracanal dressing), After‐RCT (teeth irradiated after completion of root canal treatment) and After‐FPL (teeth irradiated after luting of a glass fibre post). Each tooth received 70 Gy irradiation. The roots were sectioned for push‐out strength testing. After‐RCT and After‐FPL groups had significantly lower push‐out strength than the control at the middle third (p < 0.05). Control and After‐CH groups had a higher percentage of cohesive dentine failure. Radiotherapy after root canal obturation and post luting adversely affected the adhesiveness of resin cement to intraradicular dentine. Teeth irradiated before root canal treatment and after placement of calcium hydroxide had the best performance.

BackgroundThe literature is scanty regarding the effect of radiation therapy (RT) on the mechanical properties of immature permanent teeth.AimTo evaluate the effect of RT on the fracture resistance of simulated immature teeth submitted to different types of root reinforcement.DesignSixty‐four human teeth simulating the Cvek stage 3 of root development were distributed into eight groups (n = 8), according to exposure or not to RT (70 Gy) and the root reinforcement method: Group NR (control)—no reinforcement/no RT; Group NR + RT (control)—no reinforcement/RT; Group PO—tricalcium silicate‐based cement (TS) apical plug/canal obturation/no RT; Group PO + RT—TS apical plug/canal obturation/RT; Group TS—canal filling with TS/no RT; Group TS + RT—canal filling with TS/RT; Group FP—TS apical plug/fibreglass post/no RT; and Group FP + RT—TS apical plug/fibreglass post/RT. Fracture resistance was determined using a universal testing machine (0.5 mm/min).ResultsIn the intergroup comparison, nonirradiated teeth had higher fracture resistance (p < .05). Groups FP and FP + RT had higher fracture resistance (p < .001).ConclusionRadiotherapy affected the fracture resistance of simulated immature teeth. Reinforcement with fibreglass posts increased the fracture resistance, regardless of the radiation.