{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:12:39Z","timestamp":1789035159772,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Osteoradionecrosis (ORN) is a severe late complication of head and neck radiotherapy, often refractory to conventional treatment. Photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) have shown regenerative, analgesic, and antimicrobial effects. This report aims to describe the non\u2010invasive management of extensive mandibular ORN with intra\u2010 and extraoral fistulas using a combined PBMT\u2013PDT protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report<\/jats:title>\n                    <jats:p>A 72\u2010year\u2010old man previously treated with chemoradiation for laryngeal carcinoma developed chronic mandibular ORN after third molar extraction, complicated by a pathologic fracture, persistent suppuration, and failure of surgery, hyperbaric oxygen, antibiotics, and curettage. Clinical evaluation revealed intra\u2010 and extraoral suppurative fistulas and radiographic bone sequestration. A conservative regimen was initiated, consisting of weekly PBMT and PDT sessions following chlorhexidine irrigation. Over approximately one year (50 sessions), the patient reported progressive pain relief and reduced analgesic use. Complete closure of both fistulas was achieved, with recovery of soft\u2010tissue sensitivity and radiographic resolution of sequestration. No adverse effects occurred, and the planned surgical debridement was canceled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined PBMT and PDT promoted complete resolution of extensive, refractory mandibular ORN using a fully non\u2010invasive approach. This case highlights the synergistic potential of dual phototherapy as a safe and effective alternative when surgery is contraindicated or declined. Further studies are warranted to clarify underlying mechanisms and optimize treatment parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scd.70214","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:36:49Z","timestamp":1783928209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non\u2010Invasive Management of Osteoradionecrosis With Intra\u2010 and Extraoral Fistulas Using Combined Photodynamic and Photobiomodulation Therapy: A Case Report"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4873-1393","authenticated-orcid":false,"given":"Alyne","family":"Sim\u00f5es","sequence":"first","affiliation":[{"name":"Department of Biomaterials and Oral Biology School of Dentistry.\u00a0S\u00e3o Paulo University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Special Laboratory of Laser in Dentistry (LELO) School of Dentistry University of S\u00e3o Paulo (USP)  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3372-1536","authenticated-orcid":false,"given":"Fabio de Abreu","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Stomatology A.C. Camargo Cancer Center  S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Department of Stomatology School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6405-2270","authenticated-orcid":false,"given":"Caio Camargo","family":"Calarga","sequence":"additional","affiliation":[{"name":"Department of Biomaterials and Oral Biology School of Dentistry.\u00a0S\u00e3o Paulo University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Special Laboratory of Laser in Dentistry (LELO) School of Dentistry University of S\u00e3o Paulo (USP)  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9481-0108","authenticated-orcid":false,"given":"Luciane Hiramatsu","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Special Laboratory of Laser in Dentistry (LELO) School of Dentistry University of S\u00e3o Paulo (USP)  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Carrara","family":"Cotomacio","sequence":"additional","affiliation":[{"name":"School of Dentistry Paulista University (UNIP)  S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Pediatric Oncology Institute\/GRAACC (Support Group for Children and Adolescents with Cancer)  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/idj.12318"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2022.02.008"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010016\u20103152\u2010z"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24087094"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118987742.ch43"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278\u20102391(83)80005\u20106"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ors.12939"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphotobiol.2013.06.004"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10091106"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678\u20107757\u20102017\u20100172"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2021.102247"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics13030354"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13051042"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103\u2010017\u20102317\u20104"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2020.101959"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4317\/medoral.25729"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118987742.ch3"}],"container-title":["Special Care in Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scd.70214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/scd.70214","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scd.70214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:44:41Z","timestamp":1789033481000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/scd.70214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/scd.70214"],"URL":"https:\/\/doi.org\/10.1111\/scd.70214","archive":["Portico"],"relation":{},"ISSN":["0275-1879","1754-4505"],"issn-type":[{"value":"0275-1879","type":"print"},{"value":"1754-4505","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-11-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70214"}}