Quantitative light-induced fluorescence-guided surgery for medication-related osteomyelitis of the jaw

• Published in: Photodiagnosis and photodynamic therapy 2024-02, Vol.45, p.103867, Article 103867
• Main Authors: Kim, Yesel, Ku, Jeong-Kui
• Format: Article
• Language: English
• Subjects: Dentistry; Minimally invasive surgery; Osteomyelitis; Osteonecrosis of the jaw; Quantitative light-induced fluorescence
• ISSN: 1572-1000; 1873-1597
• DOI: 10.1016/j.pdpdt.2023.103867

•Quantitative light-induced fluorescence (QLF)-guided MRONJ surgery is possible.•QLF can be used in MRONJ surgery without any labeling agent.•When red fluorescent bone is resected, the remaining bone tissue can regenerate.•QLF-guided bone resection for MRONJ is validated to be minimally invasive. Medication-related osteonecrosis of the jaw (MRONJ) is a challenging condition with increasing incidence, and the lack of clear surgical guidelines poses difficulties in its treatment. Quantitative light-induced fluorescence (QLF), which can distinguish between vital and necrotic bone tissue without the need for additional markers, was used to guide minimally invasive surgery in a 75-year-old patient with MRONJ. This study demonstrated that QLF allows the real-time identification of infected and necrotic bone tissue during surgery, enabling precise and minimally invasive resection. We observed spontaneous bone recovery and remodeling in sclerotic bone areas that exhibited autofluorescence using a QLF device, suggesting its potential for preserving the bone tissue. This study highlights the promising application of QLF as a valuable photodiagnostic tool in MRONJ surgery, offering a noninvasive and intraoperative device for differentiating pathological bone tissue. This approach can potentially improve the precision of surgical interventions and contribute to improved patient outcomes in MRONJ management.