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Auto-Fluorescence and Histopathologic Evaluation of Medication-Related Osteonecrosis of the Jaws

Perspectives for Treatment

Giovannacci, Ilaria, DDS, MSc*,†; Vescovi, Paolo, DDS, MSc*,‡; Magnoni, Cristina, MD, PhD; Corradi, Domenico, MD§; Corcione, Luigi, MD§; Lucchina, Alberta Greco, DDS; Mortellaro, Carmen, MD, DDS; Nammour, Samir, DDS, PhD||; Meleti, Marco, DDS, PhD*

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1039–1043
doi: 10.1097/SCS.0000000000004705
Clinical Studies

Auto-fluorescence (AF) of healthy bone tissue has recently been described. Loss of AF (LAF) has, on the contrary, been reported in necrotic bone. Further, the use of LAF as a possible guidance to distinguish viable from necrotic bone during surgical treatment of osteonecrosis has been proposed. The aim of this study is to detail 8 patients of medication-related osteonecrosis of the jaws treated through an AF-guided surgical resection. The authors also provide the histopathologic description of hypo-fluorescent and hyper-fluorescent bone in each patient. After removal of necrotic bone block, Er:YAG laser was used for vaporizing further necrotic bone, up to the detection of strongly hyper-fluorescent bone. Samples of hyper-fluorescent bone were collected around areas of necrosis. Histopathologic evaluation revealed viable bone tissue in all hyper-fluorescent specimens. On the basis of these data, AF-guided surgical resection could be effective in highlighting surgical margins of necrotic bone tissue and it might have some utility in a range of applications of bone surgery.

*Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University of Parma, Parma

Department of Dermatology, University of Modena and Reggio Emilia, Modena

Department of Health Sciences, Oral Surgery Unit, University of Eastern Piedmont, Novara

§Department of Medicine and Surgery, Section of Human Pathology and Histopathology, University of Parma, Parma, Italy

||Department of Dental Sciences, University of Liège, Liège, Belgium.

Address correspondence and reprint requests to Dr Ilaria Giovannacci, DDS, MSc, Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University of Parma, Via Gramsci, 14-43125 Parma, Italy; E-mail:

Received 8 March, 2018

Accepted 7 May, 2018

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.