Comparing the effects of LLLT and gaseous ozone as a preventive measure on MRONJ following tooth extraction: A rat model

Abstract

Abstract Objectives MRONJ is a well-known severe and challenging side effect several medications since no effective treatment have been developed till date. This study aimed to evaluate the preventive effect of low-level laser therapy and gaseous ozone on the onset of MRONJ following tooth extraction. Materials and Methods A total of 40 male Wistar rats were randomly allocated into 4 groups of 10 rats each. The groups L, O and C received weekly intraperitoneal injections of zoledronic acid (0.06 mg/kg), while group S received saline solution for 4 weeks. After the 4th injection, all subjects underwent mandibular first molar extraction and adjunctive laser, or ozone were applied according to the groups. All the rats were euthanized at 4 post-operative weeks for comparative histomorphometric evaluation of bone healing in extraction sites. Results Laser and ozone groups demonstrated significantly higher bone formation compared to control group (p < .05), while no significant difference was found between laser and ozone groups (p = 1,00). Furthermore, the greatest bone formation was observed with the sham group (p < .05). Conclusions Findings of the current study support that adjunctive LLLT and ozone therapy following tooth extraction may help to prevent MRONJ and improve bone healing in subjects under BP therapy. Clinical Relevance: Since the introduction in 2003, great effort has been devoted to developing a certain management protocol for MRONJ. Several publications have appeared in recent years documenting promising results of adjunctive LLLT and ozone application in treatment of MRONJ. However, experimental data is limited on this regard and the present study, for the first time, aimed to evaluate and compare the effects of LLLT and ozone in prevention of MRONJ.