scholarly journals Use of antimicrobial photodynamic therapy in the treatment of medication-related osteonecrosis of the jaw

2021 ◽  
Vol 10 (6) ◽  
pp. 970-974
Author(s):  
Nizyara Costa da Silva Costa Da Silva ◽  
Felipe Lima E Silva ◽  
Leonardo Magalhães Carlan ◽  
Hannah Gil De Farias Morais ◽  
Weslay Rodrigues Silva ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Treatment Protocol ◽  
Osteonecrosis Of The Jaw ◽  
Antimicrobial Photodynamic Therapy ◽  
Necrotic Bone ◽  
Intravenous Injections ◽  
Antiresorptive Agents ◽  
Mandibular Region ◽  
And Control ◽  
Continuous Use

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication associated with antiresorptive agents, in which treatment can be quite challenging. This study aimed to report two cases of cancer patients with MRONJ treated in a complementary manner by antimicrobial photodynamic therapy (aPDT). Both patients were male, 84 and 82 years old, respectively, and had a diagnosis of prostate adenocarcinoma and bone metastasis, treated with intravenous injections of bisphosphonates. The dental history for both was toothache, followed by extraction of dental elements that culminated with the appearance of necrotic bone in the mandibular region, which was confirmed with imaging exams and histopathological reports. The treatment protocol for both cases consisted of performing the aPDT once a week, associated with the use of 10 volumes hydrogen peroxide and 0.12% chlorhexidine digluconate for continuous use after oral brushing and amoxicillin with clavulanate three times a day for 7 days. The patient in case 1 performed 27 sessions, responded well to treatment, however, due to complications of the underlying neoplasm, he died without complete resolution of the osteonecrosis. In case 2, 32 sessions were carried out, with a good evolution of the symptoms. The patient is being followed up for 14 months, with no need for surgical intervention to date. Based on the reported cases and the literature survey, it can be concluded that aPDT can be an effective alternative in cases of MRONJ. The patients in the study in question showed success and control of the clinical picture.

scholarly journals Application of Photodynamic Therapy in the Treatment of Osteonecrosis of the Jaw

2020 ◽  
Author(s):  
Marko Vuletić ◽  
Božana Lončar Brzak ◽  
Igor Smojver ◽  
Luka Marković ◽  
Mato Sušić ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Alveolar Bone ◽  
Treatment Protocol ◽  
Signs And Symptoms ◽  
Osteonecrosis Of The Jaw ◽  
Osteoblastic Activity ◽  
Antiresorptive Agents ◽  
Local Trauma ◽  
Mechanisms Of Development ◽  
Tissue Trauma

Osteonecrosis as term represents the death of bone tissue in the body and causes of necrosis can be different. Medication-related osteonecrosis of the jaws (MRONJ) is nowadays known as an inability of the alveolar bone to respond to a local trauma and it can result in severe local and systemic complications. In the etiology of medication-related osteonecrosis there are antiangiogenic and antiresorptive agents which have great effect on alveolar bone, producing an imbalance between resorption (osteoclastic activity) and deposition (osteoblastic activity). The exact mechanisms of development are not todays completely resolved. It is thought that it is a result from combination of medication interactions, microbiological contamination of the area and local tissue trauma. Typical signs and symptoms are painful mucosal lesions, swelling, exposed necrotic bone in the jaws, discomfort and dysesthesias. There is currently no gold standard or clearly defined treatment protocol for the disease itself. Process of treatment is demanding and main goal is to eliminate pain, control infection of soft and hard tissue and minimize progression of osteonecrosis. Besides the conventional surgical treatment, photodynamic therapy can be a viable supportive tool of initial and advanced stages of osteonecrosis and may contribute to improvements of patient′s quality of life.

scholarly journals Photodynamic Therapy as an adjunct in the Treatment of Medication-Related Osteonecrosis of the Jaw: A Case Report

2021 ◽  
Vol 12 (1) ◽  
pp. e12-e12
Author(s):  
Marcelo Vieira da Costa Almeida ◽  
Antonio C. Moura ◽  
Lúcia Santos ◽  
Luciana Gominho ◽  
Ully Dias Nascimento Távora Cavalcanti ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Case Report ◽  
Osteonecrosis Of The Jaw ◽  
Complete Regression ◽  
Antimicrobial Photodynamic Therapy ◽  
Clinical Protocols ◽  
History Of ◽  
Lesion Regression ◽  
The Right

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) corresponds to an adverse effect of the use of drugs such as bisphosphonates and denosumab. This condition is often associated with pain, infection, purulent secretion, paraesthesia, tooth mobility and halitosis, decreasing the patient’s quality of life. The management of MRONJ tends to be conservative, through the guidance of oral hygiene, antibiotic therapy and mouthwashes. However, the use of antimicrobial photodynamic therapy (aPDT) has shown promise in the treatment of these injuries. The purpose of this article is to report a case of MRONJ treatment associated with aPDT. Case Report: A 75-year-old patient, with a history of breast cancer and use of intravenous Zoledronic Acid, presented with bilateral MRONJ lesions in tuberosity on the right and left sides. Treatment was conservatively instituted with the use of aPDT as an adjuvant. After 12 aPDT sessions, complete regression of the lesion was observed. However, after two weeks, the presence of a new lesion was noted, this time in the anterior region of the maxilla. The same protocol previously established was followed and after two aPDT sessions, the patient returned with complete lesion regression. Conclusion: The use of aPDT may represent an important adjuvant within a set of clinical protocols in the treatment of MRONJ.

Regenerative treatment of peri-implantitis following implant surface decontamination with titanium brush and antimicrobial photodynamic therapy: a case series with reentry

2020 ◽  
Author(s):  
Pier Poli ◽  
Francisley Avila Souza ◽  
Mattia Manfredini ◽  
Carlo Maiorana ◽  
Mario Beretta
Keyword(s):  
Photodynamic Therapy ◽  
Clinical Case ◽  
Case Series ◽  
Antimicrobial Photodynamic Therapy ◽  
Implant Surface ◽  
Surface Decontamination

Not required for Clinical case letters according to the authors' guidelines.

scholarly journals Various Therapeutic Methods for the Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ) and Their Limitations: A Narrative Review on New Molecular and Cellular Therapeutic Approaches

Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 680
Author(s):  
Sung-Woon On ◽  
Seoung-Won Cho ◽  
Soo-Hwan Byun ◽  
Byoung-Eun Yang
Keyword(s):  
Bone Morphogenetic Proteins ◽  
Maxillofacial Surgery ◽  
Treatment Protocol ◽  
Osteonecrosis Of The Jaw ◽  
Therapeutic Modality ◽  
Definitive Treatment ◽  
Antiangiogenic Agents ◽  
Platelet Concentrates ◽  
Therapeutic Approaches ◽  
Positive Effect

Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, and various hypotheses have been proposed, such as oxidative stress-related theory. As a result, a definitive treatment protocol for MRONJ has not been identified, while various therapeutic approaches are applied to manage patients with MRONJ. Although the surgical approach to treat osteomyelitis of the jaw has been proven to be most effective, there are limitations, such as recurrence and delayed healing. Many studies and clinical trials are being conducted to develop another effective therapeutic modality. The use of some materials, including platelet concentrates and bone morphogenetic proteins, showed a positive effect on MRONJ. Among them, teriparatide is currently the most promising material, and it has shown encouraging results when applied to patients with MRONJ. Furthermore, cell therapy using mesenchymal stem cells showed promising results, and it can be the new therapeutic approach for the treatment of MRONJ. This review presents various treatment methods for MRONJ and their limitations while investigating newly developed and researched molecular and cellular therapeutic approaches along with a literature review.

scholarly journals Efficiency of Antimicrobial Photodynamic Therapy with Photodithazine® on MSSA and MRSA Strains

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 869
Author(s):  
Beatriz Müller Nunes Souza ◽  
Juliana Guerra Pinto ◽  
André Henrique Correia Pereira ◽  
Alejandro Guillermo Miñán ◽  
Juliana Ferreira-Strixino
Keyword(s):  
Staphylococcus Aureus ◽  
Photodynamic Therapy ◽  
Antimicrobial Photodynamic Therapy ◽  
Bacterial Inactivation ◽  
Bacterial Reduction ◽  
Complete Inactivation ◽  
Opportunistic Bacteria ◽  
Significant Difference ◽  
Mrsa Strains

Staphylococccus aureus is a ubiquitous and opportunistic bacteria associated with high mortality rates. Antimicrobial photodynamic therapy (aPDT) is based on the application of a light source and a photosensitizer that can interact with molecular oxygen, forming Reactive Oxygen Species (ROS) that result in bacterial inactivation. This study aimed to analyze, in vitro, the action of aPDT with Photodithazine® (PDZ) in methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) strains. The strains were incubated with PDZ at 25, 50, 75, and 100 mg/L for 15 min and irradiated with fluences of 25, 50, and 100 J/cm2. The internalization of PDZ was evaluated by confocal microscopy, the bacterial growth by counting the number of colony-forming units, as well as the bacterial metabolic activity post-aPDT and the production of ROS. In both strains, the photosensitizer was internalized; the production of ROS increased when the aPDT was applied; there was a bacterial reduction compared to the control at all the evaluated fluences and concentrations; and, in most parameters, it was obtained complete inactivation with significant difference (p < 0.05). The implementation of aPDT with PDZ in clinical strains of S. aureus has resulted in its complete inactivation, including the MRSA strains.

Porphyrin-lipid nanovesicles (Porphysomes) are effective photosensitizers for photodynamic therapy

Nanophotonics ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Keegan Guidolin ◽  
Lili Ding ◽  
Juan Chen ◽  
Brian C. Wilson ◽  
Gang Zheng
Keyword(s):  
Photodynamic Therapy ◽  
Tumor Growth ◽  
Intrinsic Structure ◽  
Therapeutic Applications ◽  
Positron Emission ◽  
Theranostic Agents ◽  
Negative Controls ◽  
And Control ◽  
Complete Tumor

Abstract Porphysomes (PS) are liposome-like nanoparticles comprising pyropheophorbide-conjugated phospholipids that have demonstrated potential as multimodal theranostic agents for applications that include phototherapies, targeted drug delivery and in vivo fluorescence, photoacoustic, magnetic resonance or positron emission imaging. Previous therapeutic applications focused primarily on photothermal therapy (PTT) and suggested that PSs require target-triggered activation for use as photodynamic therapy (PDT) sensitizers. Here, athymic nude mice bearing subcutaneous A549 human lung tumors were randomized into treatment and control groups: PS-PDT at various doses, PS-only and no treatment negative controls, as well as positive controls using the clinical photosensitizer Photofrin. Animals were followed for 30 days post-treatment. PS-PDT at all doses demonstrated a significant tumor ablative effect, with the greatest effect seen with 10 mg/kg PS at a drug-light interval of 24 h. By comparison, negative controls (PS-only, Photofrin-only, and no treatment) showed uncontrolled tumor growth. PDT with Photofrin at 5 mg/kg and PS at 10 mg/kg demonstrated similar tumor growth suppression and complete tumor response rates (15 vs. 25%, p = 0.52). Hence, porphysome nanoparticles are an effective PDT agent and have the additional advantages of multimodal diagnostic and therapeutic applications arising from their intrinsic structure. Porphysomes may also be the first single all-organic agent capable of concurrent PDT and PTT.

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