The Effect of Er:YAG Laser Therapy as an Adjunct to Surgical Treatment Compared to Latter Alone in Managing Medication-Related Osteonecrosis of the Jaw: A Randomised Controlled Clinical Trial

Objective: The aim of this double-blind randomised controlled clinical trial was to assess the effectiveness of the Er:YAG laser as an adjunct to conventional surgical treatment compared to surgical treatment alone in managing medication-related osteonecrosis of the jaw (MRONJ). Methods: Sixty-five patients diagnosed with stage II or III MRONJ were randomly allocated into 2 groups: a control group (n = 30) treated using conventional surgery alone and a test group (n = 35) treated using conventional surgery with adjunctive Er:YAG laser. All patients received 3-day preoperative and 14-day postoperative antibiotics. Follow-up assessments were scheduled at 1, 2, 4, 12, and 24 weeks postoperatively. Postoperative outcomes, including complications, disease progression, pain, and soft tissue healing, were assessed. Descriptive and inferential statistical analyses were utilised. Results: Compared to conventional surgery alone, adjunctive Er:YAG laser therapy resulted in significantly reduced postoperative complication rates (17.1% vs 60%, P < .001), improved mucosal healing (85.7% vs 26.7%, P < .001), and reduced pain. The laser-assisted procedure, however, was significantly longer (70.03 vs 57.90 minutes, P < .001). Conclusions: Incorporating Er:YAG laser therapy as an adjunct to conventional surgical treatment for MRONJ (stages II and III) positively influenced clinical outcomes by enhancing soft tissue healing and reducing postoperative complications.