From: New approach for the treatment of osteoradionecrosis with pentoxifylline and tocopherol
Osteoradionecrosis of jaw | |
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Characteristics | Irradiated bone becomes devitalized and exposed through the overlying skin or mucosa without healing for 3months, without recurrence of tumor |
Most case happen in mandible | |
70-94% of cases developed within the first 3 years after radiotherapy | |
Risk factors | Hyperfractionated irradiation regimen - High total dose (6000-7000cGy) |
Recent reports have suggested that when chemotherapy is added to radiotherapy the incidence of ORN may be increased | |
Pre-irradiation and post-irradiation dental extractions | |
Poor oral hygien with periodontal disease | |
Tobacco and alcohol use | |
Conservative treatment | Improve oral hygiene |
Minimal surgical debridement | |
Hyperbaric oxygen therapy (HBOT) | |
Medical management: pentoxifylline, tocopherol | |
Surgical treatment | Sequestrectomy, Saucerization |
Segmental resection and Free flap reconstruction |