Clinical outcome and volumetric 3D analysis of biofluorescence imaging system guided surgery for Medication-Related Osteonecrosis of the Jaw(MRONJ).

Abstract

Background: This study aims to evaluate the clinical outcome of biofluorescent imaging system (BIS) guided MRONJ surgery through analyzing 3D volumetric changes in CBCT data of bone structure.

Methods: BIS-guided surgery for MRONJ surgery was performed by grinding red-fluorescent area from remained residual bone detected by Qray-pen. CBCT data was collected preoperatively, postoperatively, and at last follow-up more than 3 months of each patient. Healing ratio per month was calculated through measuring difference between postoperative defect and last follow-up defect volume by analyzing CBCT.

Results: With mean follow-up period of 7.8 ± 4.8 months, twelve MRONJ surgeries of 11 patients (2 males, 9 females, mean 72.8 ± 13.7 years old) showed bone healing tendency without recurrence in average healing ratio of 5.49 ± 2.22% per month, with complete soft tissue closure. It was observed that the healing ratio per month did not show statistically significant differences based on location of MRONJ, size of post-operative defect volume, nor duration of bisphosphonate intake before surgery.

Conclusions: Based on three-dimensional bone analysis, efficacy of BIS-based MRONJ surgery was proved through the recovery pattern of underlying bone structure and no recurrence sign showing.

Clinical trial registration: Not applicable.