Comparison of auto-fluorescence and tetracycline fluorescence for guided bone surgery of medication-related osteonecrosis of the jaw: a randomized controlled feasibility study

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• 作者：O. Ristow¹ ; ^{oliver.ristow@med.uni-heidelberg.de} ; S. Otto² ; C. Geiß ; ² ; ³ ; V. Kehl⁴ ; M. Berger¹ ; M. Troeltzsch² ; S. Koerdt⁵ ; B. Hohlweg-Majert³ ; ⁵ ; C. Freudlsperger¹ ; C. Pautke² ; ³
• 关键词：necrosis of the jaw ; BRONJ ; DRONJ ; MRONJ ; ONJ ; bisphosphonate ; osteonecrosis ; bone fluorescence ; tetracycline ; auto-fluorescence ; therapy ; bone ; VELscope
• 刊名：International Journal of Oral and Maxillofacial Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：46
• 期：2
• 页码：157-166
• 全文大小：1134 K
• 卷排序：46

文摘

Recent studies have indicated that bone shows auto-fluorescence under an appropriate fluorescence lamp. The aim of this preliminary study was to compare the success rates of the established tetracycline fluorescence-guided bone surgery with auto-fluorescence-guided bone surgery in the treatment of medication-related osteonecrosis of the jaw (MRONJ). Forty patients suffering from MRONJ were referred for surgical treatment and were divided randomly into two groups: auto-fluorescence (n = 20) or tetracycline fluorescence (n = 20) guided bone surgery. The primary endpoint was treatment success, defined as the absence of exposed bone at 8 weeks after surgery. Secondary outcomes assessed were mucosal integrity, signs of infection, pain, and loss of sensitivity; these were evaluated descriptively at 10 days, 8 weeks, 6 months, and 1 year after surgery. At 8 weeks postoperative, 18/20 patients (90%) in the auto-fluorescence group and 17/20 patients (85%) in the tetracycline fluorescence group showed mucosal integrity (P > 0.05). At the last follow-up, 94% in the auto-fluorescence group and 89% in the tetracycline fluorescence group presented complete mucosal coverage with no exposed bone, infection, or pain (P > 0.05). There was no significant difference between the two techniques for any of the secondary outcomes (P > 0.05). The results of this preliminary study show that auto-fluorescence-guided bone surgery has comparable success rates to the established tetracycline fluorescence-guided bone surgery.