Association of photobiomodulation and antimicrobial photodynamic therapy in healing after multiple extraction in head and neck post-radiotherapy- a case report and literature review

Purpose: To report a clinical case involving the use of photobiomodulation (PBMT) and antimicrobial photodynamic therapy (aPDT) in the management of delayed healing after multiple extractions in a patient irradiated in the head and neck region. Case report: A 62-year-old male patient sought the service complaining of fractured teeth, difficulty chewing and aesthetic impairment. Ten years ago, he was diagnosed with infiltrative squamous cell carcinoma (SCC) on the tongue edge and underwent radiotherapy. The intraoral physical examination revealed caries and extensive bone resorption in the teeth 43, 42 and 33, and fracture of the crown of the tooth 34, thus, it was decided to perform their extraction. After the procedure, PBMT was performed on the entire sutured area with a wavelength of 660 nm, 0.5 J, for 5 s. Then, the buccal and lingual bone plates were irradiated, with a wavelength of 808 nm, 1 J, for 10 s, with the tip in contact with the tissue at both wavelengths. Associated with PBMT, aPDT was performed with 0.01% methylene blue, radiating with a wavelength of 660 nm and 4 J. Conclusion: The PBMT associated with aPDT was an effective and safe modality, with no intercurrences in both surgeries, and the patient did not report pain or any discomfort in the postoperative period. The patient was rehabilitated with upper and lower total prosthesis, and has been proserved for 24 months, with no sign of bone necrosis, or any other alteration. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024.