Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy

El-Rabbany, Mohamed; Duchnay, Michael; Raziee, Hamid; Zych, Maria Maddalena; Tenenbaum, Howard C.; Shah, Prakeshkumar S; Azarpazhooh, Amir

doi:10.1002/14651858.cd011559.pub2

Cited by 22 publications

(37 citation statements)

References 36 publications

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“…Interestingly, they found an enhanced bone formation and a reduced gap size in G-CSF-treated animals, most likely caused by the induction of early neovascularization. 62 These results are supported by Ishida et al, 84 who found an increased capillary density in bone defects after local and systemic G-CSF treatment. Therefore, G-CSF represents a promising compound to enhance vascularization in bone regeneration.…”

Section: Systemic Pharmacological Treatmentmentioning

confidence: 56%

“…Hence, one of the major challenges will be the development of well-designed and conclusive clinical trials to prove the efficiency of HBO treatment in bone regeneration. 61,62 Moreover, HBO is associated with severe side effects, including visual changes, nausea, dizziness, convulsion as well as the formation of free oxygen radicals, which may have cytotoxic effects on cells and tissues. 63 Electric stimulation (EStim) is another biophysical application, which is used in the field of bone regeneration.…”

Section: Biophysical Applicationsmentioning

confidence: 99%

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Vascularization Strategies in the Prevention of Nonunion Formation

Menger

Laschke

Orth

et al. 2021

Tissue Engineering Part B: Reviews

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Delayed healing and nonunion formation are major challenges in orthopedic surgery, which require the development of novel treatment strategies. Vascularization is considered one of the major prerequisites for successful bone healing, providing an adequate nutrient supply and allowing the infiltration of progenitor cells to the fracture site. Hence, during the last decade, a considerable number of studies have focused on the evaluation of vascularization strategies to prevent or to treat nonunion formation. These involve (1) biophysical applications, (2) systemic pharmacological interventions, and (3) tissue engineering, including sophisticated scaffold materials, local growth factor delivery systems, cell-based techniques, and surgical vascularization approaches. Accumulating evidence indicates that in nonunions, these strategies are indeed capable of improving the process of bone healing. The major challenge for the future will now be the translation of these strategies into clinical practice to make them accessible for the majority of patients. If this succeeds, these vascularization strategies may markedly reduce the incidence of nonunion formation.

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Section: Systemic Pharmacological Treatmentmentioning

confidence: 56%

Section: Biophysical Applicationsmentioning

confidence: 99%

Vascularization Strategies in the Prevention of Nonunion Formation

Menger

Laschke

Orth

et al. 2021

Tissue Engineering Part B: Reviews

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“…The fact that extractions were done by experienced maxillofacial surgeons and carried out with minimal trauma [42] suggests that an atraumatic procedure is an important factor to prevent ORN. Importantly, hyperbaric oxygen therapy [43,44] was not systematically prescribed and pentoxifylline and tocopherol [45] were never used for our patients due to the lack of evidence backing their use [46]. Pentoxifylline and tocopherol should be considered only for the management of advanced ORN where surgical management is not appropriate [47,48].…”

Section: Discussionmentioning

confidence: 99%

Incidence of osteoradionecrosis of the jaws: A retrospective study of 620 head and neck cancer patients treated by radiotherapy

Kabir

Durand

Roberge

et al. 2020

Preprint

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Background This study aims to assess systemic and local risk factors influencing the development of osteoradionecrosis of the jaws (ORN) and its incidence in head and neck cancer patients undergoing radiotherapy.Methods This was a retrospective cohort study of 620 adult patients following radiation for a head and neck cancer in 2011 or 2012. Results Of the 181 patients who did not require any extraction, the incidence of ORN was 0.5%. Of the 266 patients with 1491 dental extractions (mean 5.5 teeth per patient) performed before radiotherapy, the incidence of ORN was 3.7%. ORN was always observed in extraction sites located in the field of radiation. No dental extractions were done during radiotherapy. Of the 20 patients with 53 dental extractions (mean 2.7 teeth per patient) performed after radiotherapy, 15 teeth were located in the field of radiation. No case of ORN was reported in that group. For edentulous patients, ORN incidence was 1.7%. Conclusion Within the limitations of this study, the incidence of ORN can be minimized with a meticulous pre-radiotherapy dental examination, a comprehensive treatment plan and diligent post-radiotherapy follow-ups conducted by an experienced multidisciplinary team.

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“…The treatment of ORNJ is based on the severity and remains challenging. Current treatment modalities range from antibiotic therapy, combination therapy with pentoxifylline, tocopherol and/or clodronate, hyperbaric oxygen therapy and surgical intervention [ 37 – 39 ]. Other significant oral manifestations arising from HNRT include permanent salivary gland hypofunction and trismus which can occur at radiation doses as low as 20 and 50 Gy, respectively [ 40 – 43 ].…”

Section: Indicationsmentioning

confidence: 99%

Dental Evaluation Prior to Cancer Therapy

Yong

Robinson

Hong

2022

Front. Oral. Health

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A comprehensive oral examination and dental care prior to the start of cancer therapy is the standard of care in many cancer centers. This is because good oral health will likely minimize the undesirable complications such as opportunistic infections during cancer therapy. As the considerations differ between anti-neoplastic regimens, this chapter discusses the indications and rationale when planning and executing a treatment plan for patients undergoing various cancer therapies.

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Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy

Cited by 22 publications

References 36 publications

Vascularization Strategies in the Prevention of Nonunion Formation

Vascularization Strategies in the Prevention of Nonunion Formation

Incidence of osteoradionecrosis of the jaws: A retrospective study of 620 head and neck cancer patients treated by radiotherapy

Dental Evaluation Prior to Cancer Therapy

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