SEGMENTAL BONE RESECTION ASSOCIATED WITH PHOTOBIOMODULATION AND PHOTODYNAMIC THERAPY IN THE TREATMENT OF DRUG-RELATED OSTEONECROSIS OF THE JAW: CASE REPORT AND LITERATURE REVIEW

Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with the use of antiresorptive and/or antiangiogenic therapies, representing a significant therapeutic challenge. To report the successful management of an advanced case of MRONJ in the mandible using a multimodal therapeutic approach. A 56-year-old female patient with a history of breast cancer and bone metastasis, treated with zoledronic acid for four years. After tooth extraction, she developed bone exposure and purulent drainage. Treatment consisted of marginal bone resection of necrotic tissue, combined with intraoperative antimicrobial photodynamic therapy (aPDT) and postoperative photobiomodulation (PBMT) sessions. The patient presented satisfactory healing, was rehabilitated with a prosthesis, and, after 12 months of follow-up, showed no signs of recurrence. The combined approach of resective surgery with adjuvant photonic therapies (aPDT and PBMT) proved to be an effective strategy in resolving the condition, promoting the patient's rehabilitation and improving her quality of life