Abstract
The feasibility of laser-assisted treatments of medication-related osteonecrosis of
the jaw (MRONJ) remains poorly understood, so we have therefore systematically evaluated
their effectiveness. We made a comprehensive search of MEDLINE, Pubmed, and Embase
to find randomised controlled trials, case-control studies, and prospective cohort
studies that assessed them. We assessed the eligible studies in duplicate, and if
possible conducted a meta-analysis. Ten studies with a low to high risk of bias met
the inclusion criteria. We found that a comparison of pain scores before and after
using visible and infrared GaAs laser in the low-level laser treatment based on the
Numerical Pain Rating Scale (mean difference 4.28; 95% CI 3.62 to 4.93; p < 0.00001), showed that there were significant differences in the amount of pain. The
effectiveness of other laser-assisted treatments on the reduction of pain – for example,
Er:YAG laser surgical treatment, and laser-assisted treatment plus platelet-rich plasma,
and the effect of other techniques on wound healing of laser-assisted treatments,
are uncertain. We found that the results of the studies that were deemed to be high-to-low
quality and to have high-to-low statistical power suggested that there may be considerable
clinical improvement in MRONJ by using laser-assisted treatment; we cautiously consider
that low-level laser treatment may manage pain and symptoms in these patients. More
randomised studies of good quality and with a low risk of bias are needed to test
whether laser-assisted treatment should be a routine part of management of patients
with MRONJ.
Keywords
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Article info
Publication history
Published online: January 13, 2020
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© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
