Differences between osteoradionecrosis and medication-related osteonecrosis of the jaw

Akashi, Mitsuru; Wanifuchi, Satoshi; Iwata, Eiji; Takeda, Daisuke; Kusumoto, Junya; Furudoi, Shungo; Komori, Takahide

doi:10.1007/s10006-017-0667-5

Cited by 32 publications

(25 citation statements)

References 17 publications

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“…Over the past two decades, radiation delivery has evolved from three‐dimensional conformal RT (3D‐CRT) to intensity‐modulated RT (IMRT) and volumetric modulated arc therapy (VMAT), which uses computed tomography‐based planning and radiation delivery aided by computerised optimisation of multiple beam intensities 38 . The use of IMRT and VMAT reduces RT‐related complications, improves the patient quality of life, increases the survival rate and oncological prognosis and reduces ORNJ risk 38‐41 . In Taiwan, conventional 2DRT and 3D‐CRT have rapidly been replaced by IMRT or VMAT since 2009 24,25 .…”

Section: Discussionmentioning

confidence: 99%

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Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan

Liao

Chu

Tang

et al. 2020

Clinical Otolaryngology

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Head and neck cancer (HNC), representing 3% of all cancers, has been ranked as the sixth to eighth most common cancer type, with increasing global prevalence. 1 Despite advances in treatment, the mortality and morbidity rates remain high. 2 More than 70% of patients with HNC require radiotherapy (RT). 3,4 Oral complications (both acute and chronic effects) are common in patients receiving RT involving the oral cavity, including mucositis, infection, saliva change, fibrosis, sensory dysfunction, dental caries, periodontal disease and osteoradionecrosis. 5 Osteoradionecrosis, the most severe chronic complication, is difficult to treat clinically and is painful for patients. 6 Patients receiving head and neck RT should be dentally consulted before initial RT treatment to establish an appropriate oral

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Section: Discussionmentioning

confidence: 99%

“…proves the patient quality of life, increases the survival rate and oncological prognosis and reduces ORNJ risk. [38][39][40][41] In Taiwan, conventional 2DRT and 3D-CRT have rapidly been replaced by IMRT or VMAT since 2009. 24,25 Therefore, when analysing the effect of the RT modality on ORNJ risk, 2009 was defined as the cut-off year.…”

Section: Rt Modalitiesmentioning

confidence: 99%

Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan

Liao

Chu

Tang

et al. 2020

Clinical Otolaryngology

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“…It is well recognized that ORNJ is more progressive than MRONJ with a higher rate of complications such as pathologic fractures and extra-oral stulae [34,35]. Periosteal blood supply is more affected in ORNJ than MRONJ, probably explaining the worse ORNJ treatment outcomes [36]. A recent study reported a complete mucosal healing rate of 81.7% (67 of 82) after uorescence-guided bone removal in MRONJ patients [20].…”

Section: Discussionmentioning

confidence: 99%

Fluorescence-guided Surgery of Osteoradionecrosis of the Jaw: A Retrospective Study

Aljohani

T²,

Chronopoulos

et al. 2021

Preprint

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BackgroundOsteoradionecrosis of the jaw (ORNJ) is one of the most severe head and neck complications in patients treated with radiotherapy (RT), and it is one of the diseases difficult to manage. The goal of the treatment is to achieve mucosal healing or suppress ORNJ progression. Currently, surgical removal of the necrotic bone is an effective management approach for advanced stages of ORNJ. This study aimed to identify the outcomes of fluorescence-guided surgery for ORNJ. MethodsNineteen ORNJ lesions in 15 hospitalized patients received fluorescence-guided surgery. Demographics, comorbidities, local preceding event, location, ORNJ stage, and treatment outcomes were retrospectively reviewed with a median follow-up period of 12 months.ResultsThe first 12 lesions (63%) were operated under tetracycline fluorescence, and 7 lesions (37%) were operated under auto-fluorescence. Overall, 4 lesions (21%) achieved complete mucosal healing, 8 lesions (42%) showed partial mucosal healing with bone exposure and no signs or symptoms of inflammation, and 7 lesions (37%) were progressive. The results showed that either healing or ORNJ stabilization was achieved in 63% of the lesions (n = 12). No significant association was observed between healing and the fluorescence technique.ConclusionFluorescence-guided surgery can be beneficial in curing or stabilizing ORNJ. Within the study limitations, autofluorescence-guided surgery seems to be as effective as tetracycline fluorescence-guided surgery for management of ORNJ. Trial registration: not applicable

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“…There is some evidence available on various reconstruction techniques, including mandibular reconstruction plates, autogenous bone grafts, regional flaps, and free tissue transfers in patients with ORN of the jaw rather than with MRONJ. [23][24][25] These studies have concluded that it is essential to be aware of the potential failures of reconstruction plates, particularly in patients with ORN who have received irradiation and therefore would exhibit wound healing problems.…”

Section: Discussionmentioning

confidence: 99%

Treatment of medication‐related osteonecrosis of the jaw using segmental mandibulectomy and a reconstruction plate: A case report and 5‐year follow‐up

Kamaguchi

Ohga

Hata

et al. 2021

Oral Science International

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Bisphosphonates (BPs) are antiresorptive agents that are widely used in the prevention and treatment of osteoporosis, Paget's disease, multiple myeloma, and bone metastasis of solid tumors. [1][2][3][4] As BPs effectively reduce osteoporosis-related bone fractures, they are used as a first-line therapy for the treatment of the primary osteoporosis. 5 Despite the therapeutic benefits of BPs, antiresorptive or antiangiogenic agents are associated with medication-related osteonecrosis of the jaw (MRONJ). 6 Systemic risk factors for MRONJ include duration of exposure to antiresorptive agents, age, use of corticosteroids, presence of comorbidities, and smoking, 7,8 whereas local risk factors include invasive dental treatments such as tooth extractions, uncontrolled periodontitis, inappropriate denture use, and poor oral hygiene. 9-11 Moreover, the management of bone metastasis by intravenous administration of high-dose BPs has been reported to

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Differences between osteoradionecrosis and medication-related osteonecrosis of the jaw

Abstract: Understanding the clinical and underlying pathological differences between ORN and MRONJ probably contributes to the selection of appropriate treatment for each patient.

Cited by 32 publications

References 17 publications

Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan

Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan

Fluorescence-guided Surgery of Osteoradionecrosis of the Jaw: A Retrospective Study

Treatment of medication‐related osteonecrosis of the jaw using segmental mandibulectomy and a reconstruction plate: A case report and 5‐year follow‐up

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