Tooth extractions in high-risk patients previously treated for osteonecrosis. Protocol supported by low level laser therapy

Trauma during dental surgery is the main predisposing factor for Medication Related Osteonecrosis of the Jaws (MRONJ). The Authors proposed in 2013 a successful protocol for extractions in patients under BPT supported by Nd:YAG lowlevel laser therapy (LLLT). The aim was to validate this protocol reporting the data related to its application in highrisk patients because previously affected with MRONJ. Eighty-two tooth extractions were performed in 36 patients at the Center of Oral Surgery and Oral Medicine of the University of Parma, Italy. Forty-nine tooth extractions were performed in 21 patients who were previously, successfully treated for MRONJ in a site different from the extraction site. Thirty-nine extractions were performed in 14 cancer patients and 10 in 7 osteoporotic patients. Thirty-three extractions were performed in 15 patients who had MRONJ in the same site of extraction. Antibiotic treatment was administered starting 3 days before extraction for at least 2 weeks until complete mucosal healing. Mean follow-up was 18.66 months in G1, 13.93 months in G2.