Fluorescence-guided Surgery for Osteonecrosis of the Jaws: Implications for Bone Preservation
Gean Erick da Rocha de Maria
Federal University of Ceará, Fortaleza, Ceará, Brazil.
Yann Nobre Viana
Federal University of Ceará, Fortaleza, Ceará, Brazil.
Carline Baessa Tavares
Federal University of Ceará, Fortaleza, Ceará, Brazil.
Mateus Jorge Moreira *
Federal University of Ceará, Fortaleza, Ceará, Brazil.
Marcelo Ferraro Bezerra
Federal University of Ceará, Fortaleza, Ceará, Brazil.
Francisco Samuel Rodrigues Carvalho
Federal University of Ceará, Fortaleza, Ceará, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Osteonecrosis of the jaws is a serious condition characterized by bone necrosis, generally associated with medication therapies or radiotherapy. Appropriate surgical management is essential to minimize complications and promote functional recovery.
Objectives: This review aims to analyze the effectiveness of bone fluorescence as a guide for the surgical treatment of osteonecrosis of the jaws, comparing different protocols described in the literature.
Methodology: An integrative literature review was conducted, selecting 20 studies that addressed the use of bone fluorescence techniques involving tetracycline, doxycycline, minocycline, autofluorescence, or the Er:YAG laser in the surgical management of osteonecrosis.
Results: The use of fluorescence, especially when associated with fluorescent antibiotics and devices such as VELscope®, enabled improved delimitation of necrotic bone, achieving success rates above 85%. Autofluorescence was also effective, although its accuracy may be compromised by the presence of blood in the surgical field.
Discussion: Bone fluorescence enables precise removal of compromised tissue while preserving viable bone, promoting better healing outcomes. Protocols combining fluorescent antibiotics with specialized illumination systems demonstrated superior results compared to conventional techniques.
Conclusion: Fluorescence-guided surgery represents a safe and efficient approach for treating osteonecrosis of the jaws, providing greater surgical precision, bone preservation, and improved clinical prognosis.
Keywords: Osteonecrosis of the jaws, fluorescence-guided surgery, autofluorescence, tetracycline fluorescence, bone preservation