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Comparative Study
. 2024 Nov 11;21(15):2959-2973.
doi: 10.7150/ijms.93224. eCollection 2024.

Comparison of the Effects of Four Laser Wavelengths on Medication-Related Osteonecrosis of the Jaw (MRONJ) in a Murine Model: An In Vivo Photobiomodulation Study

Mustafa Ayhan  1 , Betul Gedik  1 , Ekrem Emir Kalelioglu  1 , Abdulsamet Kundakcioglu  1 , Canan Kucukgergin  2 , Cevat Tugrul Turgut  1 , Humeyra Kocaelli  1 , Fatma Canan Alatli  3 , Halim Issever  4 , Evin Ademoglu  2 , Mehmet Yaltirik  1
Affiliations
Comparative Study

Comparison of the Effects of Four Laser Wavelengths on Medication-Related Osteonecrosis of the Jaw (MRONJ) in a Murine Model: An In Vivo Photobiomodulation Study

Mustafa Ayhan et al. Int J Med Sci. .

Abstract

Background: This study aims to investigate the effectiveness of lasers at various wavelengths in treating medication-related osteonecrosis of the jaw (MRONJ) using biochemical, clinical scoring, micro CT analysis, and histopathological methods. The study follows the ARRIVE guidelines to ensure robust and transparent research. Methods: In our study, there were 6 groups, including one SHAM group, one CONTROL group, and four experimental groups, with 8 rats in each individual group. Each rat received antiresorptive drug intraperitoneally for 4 weeks and then had the left second molar in the mandible extracted. All animals were sacrificed at the end of the 12th week. In the experimental groups, lasers at wavelengths of 405nm, 445nm, 660nm, and 808nm were applied to the animals. Parameters such as serum vitamin D levels, bone density and bone volume at the extraction site, new bone formation, dead bone count, inflammatory cell count, and epithelial regeneration were examined. Additionally, clinical scoring was conducted after sacrifice. The laser parameters included power density, area, time, fluence, and mode (continuous wave), and the light was administered using a fiber with a Gaussian profile. Statistical analyses were performed with the NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package program. The results were evaluated at the p<0.05 significance level. Results: According to the results obtained from our study, new bone formation in all experimental groups was significantly higher than in the SHAM and CONTROL groups. Furthermore, the 660nm and 808nm wavelengths increased serum vitamin D levels significantly. The most successful outcomes were observed in clinical scoring, dead bone count, epithelial cell regeneration, and bone density in the 660nm and 808nm wavelength groups. Conclusions: The combined use of lasers at 660nm and 808nm wavelengths may yield successful results in treating MRONJ.

Keywords: Dentistry; Laser therapy; Medication-related osteonecrosis of the jaw; Oral surgery; Photobiomodulation therapy; Vitamin D; Zoledronate.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Clinical findings. An Empty well, healed socket of the extracted teeth B Hyperemic mucosa around the extraction site C Extraction site with impaired soft tissue integrity and bone exposure D Abscess and suppuration.
Figure 2
Figure 2
Raw image and sectional view.
Figure 3
Figure 3
Determination of ROI (Region of Interest) around the analysis area.
Figure 4
Figure 4
Determination of threshold value for the relevant field.
Figure 5
Figure 5
Mean serum Vitamin D levels in different study groups.
Figure 6
Figure 6
Clinical Scoring.
Figure 7
Figure 7
Mean bone mineral density levels in different study groups.
Figure 8
Figure 8
Mean bone volume levels in different study groups.
Figure 9
Figure 9
New bone formation levels in different study groups.
Figure 10
Figure 10
New bone formation. A In the SHAM group, there is a live bone in the form of bands in the defect area, on and around the tooth germ, areas of new bone formation in the environment, and dead bone areas in the near-surface areas. H&E, X40. B In the control group, there are dead bone fragments on the surface, live bone on both sides, and new bone formation areas around the granulation tissue in the middle section of the defect area. H&E, X40. C In the laser 405 nm, live bone in the defect area, lower margin, granulation tissue, and dead bone fragments at the left end and new bone formation in large areas are observed. H&E, X40. D In the laser 445 nm, dead bone, live bone, and new bone formation areas are observed in the defect area around the tooth, and a small amount of granulation tissue is observed. H&E; X40. E In the laser 660 nm, intense new bone formation is observed around the tooth, between the living bone areas. H&E; X40. F In the laser 808 nm, dense new bone formation and granulation tissue are seen between living bones. H&E; X40.
Figure 11
Figure 11
Mean dead bone counts in different study groups.
Figure 12
Figure 12
Dead bone count. A In the control group, granulation tissue, and minimal new bone formation were seen between large areas of dead bone. H&E; X40. B In the Laser 660 nm group, inflammation, and granulation tissue were observed around the dead bone fragments. H&E; x100.
Figure 13
Figure 13
Mean epithelial cell regeneration values in different study groups.
Figure 14
Figure 14
Epithelial cell regeneration. A In the control group, epithelial regeneration was observed on the wound surface. H&E; X40. B In the Laser 660 nm group, epithelial regeneration was observed on the wound surface. H&E; X40. C In the Laser 808 nm group, epithelial regeneration was observed that covers the defect area and surrounds the deep dead bone. H&E; X40.
Figure 15
Figure 15
Mean inflammation cell counts in different study groups.
Figure 16
Figure 16
Inflammation Cell Count. A In the SHAM group, areas of inflammation were observed around dead bone fragments. H&E; x100. B In the 445 nm group, intense inflammation, and granulation tissue formation were observed around the new bone formation. H&E; x100.
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