Nd:YAG laser biostimulation of bisphosphonate-associated necrosis of the jawbone with and without surgical treatment

Bisphosphonate-associated osteonecrosis was first reported in 2003 and is getting common. Size of lesions, symptoms, and duration of time between starting bisphosphonates and the development of bone necrosis vary. There is currently no effective treatment. We describe our preliminary results with 19 patients affected by bisphosphonate-associated osteonecrosis of the jaws who were treated conventionally with surgical or medical treatment alone or in combination with neodimium: yttrium-aluminium-garnet (Nd:YAG) laser. Clinical variables such as symptoms, presence of pus, and closure of mucosal flaps before and after treatment were evaluated to establish the effect of the laser irradiation. We treated nine patients with laser biostimulation with or without surgical treatment, and in this group there were eight clinical successes and one symptomatic improvement, with a clinical finding better than ones without laser biostimulation (ten patients, five clinical successes, and one symptomatic improvement).