Use of a generic violet light in the surgical management of medication-related osteonecrosis of the jaws: a technical note

Abstract

Purpose

Fluorescence-guided surgery has been recommended for the diagnosis of bone margins in cases of mandibular osteonecrosis. In this article, we report a case in which a generic violet light was used in order to activate bone fluorescence after the administration of tetracycline derivatives, as an alternative to a specific, more expensive equipment that is commercially available for this purpose. The patient had been using alendronate for osteoporosis, resulting in medication-related osteonecrosis of the jaws.

Methods

The treatment protocol includes preoperative administration of doxycycline and the application of a generic violet light during surgery in order to observe the fluorescence of bone in response to excitation through the light emitted by this device.

Results

With an effective visualization of the limit between healthy and devitalized bone tissue, it was possible to perform the necrotic tissue removal. The lesion regressed from stage 2 to stage 0, with no clinical or radiographic evidence of necrotic bone.

Conclusions

These results suggest the feasibility of using a generic violet light source as a low-cost alternative for fluorescence-guided surgery.

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