Osteonecrosis: photobiomodulation and photodynamic therapy - a systematic review

A wide range of adjuvant treatments have been studied to treat osteonecrosis. Photobiomodulation and photodynamic therapy are commonly used. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review was conducted to evaluate photobiomodulation and photodynamic therapy for the treatment of osteonecrosis related to the use of medications or related to ionising radiation. After searching PubMed, EMBASE, LILACS and Livivo Database, 2 systematic reviews, 4 prospective comparative studies, 10 comparative studies and 23 retrospective case reports were selected. Photobiomodulation-positive outcomes were observed in pain management and healing linked to osteonecrosis of the jaw due to antiresorptive drugs. Limited studies exist on photodynamic therapy and osteoradionecrosis. No adverse effects were reported. Despite the low quality of evidence, findings suggest that photobiomodulation may serve as an adjuvant therapy for osteoporotic patients, particularly those ineligible for surgery. Similar benefits were noted for oncological patients, but controlled trials evaluating cancer-related outcomes are lacking, emphasising the need for further research.