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Table 1 Characteristics, risk factors, conservative and surgical treatment of ORN [[913]

From: New approach for the treatment of osteoradionecrosis with pentoxifylline and tocopherol

 

Osteoradionecrosis of jaw

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