Evidence map›Paper›PMID 42438445›Full record

ArticleSpecial care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry

Non-Invasive Management of Osteoradionecrosis With Intra- and Extraoral Fistulas Using Combined Photodynamic and Photobiomodulation Therapy: A Case Report.

Alyne Simões, Fabio de Abreu Alves, Caio Camargo Calarga, Luciane Hiramatsu Azevedo, Claudia Carrara Cotomacio

Abstract readCase Reports
In one paragraph

Article in Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alyne SimõesDepartment of Biomaterials and Oral Biology, School of Dentistry. São Paulo, University of São Paulo, São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-4873-1393
Fabio de Abreu AlvesDepartment of Stomatology, A.C. Camargo Cancer Center, São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-3372-1536
Caio Camargo CalargaDepartment of Biomaterials and Oral Biology, School of Dentistry. São Paulo, University of São Paulo, São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-6405-2270
Luciane Hiramatsu AzevedoSpecial Laboratory of Laser in Dentistry (LELO), School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-9481-0108
Claudia Carrara CotomacioSchool of Dentistry, Paulista University (UNIP), São Paulo, São Paulo, Brazil.

Funding

Brazilian National Council for Scientific and Technological Development (CNPq) #308100/2025-5Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. 88887.859011/2023-00USP/FUSP/Santander Program 2019/FO2019.1.510.23.8
6 · The paper itself

Abstract

aimsOsteoradionecrosis (ORN) is a severe late complication of head and neck radiotherapy, often refractory to conventional treatment. Photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) have shown regenerative, analgesic, and antimicrobial effects. This report aims to describe the non-invasive management of extensive mandibular ORN with intra- and extraoral fistulas using a combined PBMT-PDT protocol. CASE REPORT: A 72-year-old man previously treated with chemoradiation for laryngeal carcinoma developed chronic mandibular ORN after third molar extraction, complicated by a pathologic fracture, persistent suppuration, and failure of surgery, hyperbaric oxygen, antibiotics, and curettage. Clinical evaluation revealed intra- and extraoral suppurative fistulas and radiographic bone sequestration. A conservative regimen was initiated, consisting of weekly PBMT and PDT sessions following chlorhexidine irrigation. Over approximately one year (50 sessions), the patient reported progressive pain relief and reduced analgesic use. Complete closure of both fistulas was achieved, with recovery of soft-tissue sensitivity and radiographic resolution of sequestration. No adverse effects occurred, and the planned surgical debridement was canceled.

conclusionCombined PBMT and PDT promoted complete resolution of extensive, refractory mandibular ORN using a fully non-invasive approach. This case highlights the synergistic potential of dual phototherapy as a safe and effective alternative when surgery is contraindicated or declined. Further studies are warranted to clarify underlying mechanisms and optimize treatment parameters.

Indexed as

FistulaLow-Level Light TherapyMandibular DiseasesOsteoradionecrosisPhotochemotherapyAgedCombined Modality TherapyHumansMaleantimicrobial photodynamic therapycase reporthead and neck neoplasmslow‐level laser therapyosteoradionecrosisradiotherapy

Identifiers

PMID42438445
PMCPMC13358455

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.