Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients—a report of a thirty year retrospective review

Reuther, T.; Schuster, Tobias; Mende, Ulrich; Ac, Kübler

doi:10.1054/ijom.2002.0332

Cited by 425 publications

(411 citation statements)

References 26 publications

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“…It is thought to result from osteocyte and microvascular damage after the jaws are exposed to ionizing radiation and also frequently occurs after tooth extraction (56). Osteoradionecrosis, however, infrequently involves the maxilla (Ͻ5% of cases) and is more common in men than in women (57,58).…”

Section: Oral Complications Of Bisphosphonate Therapymentioning

confidence: 99%

Systematic Review: Bisphosphonates and Osteonecrosis of the Jaws

2006

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Osteonecrosis of the jaws is a recently described adverse side effect of bisphosphonate therapy. Patients with multiple myeloma and metastatic carcinoma to the skeleton who are receiving intravenous, nitrogen-containing bisphosphonates are at greatest risk for osteonecrosis of the jaws; these patients represent 94% of published cases. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60% of cases are preceded by a dental surgical procedure. Oversuppression of bone turnover is probably the primary mechanism for the development of this condition, although there may be contributing comorbid factors. All sites of potential jaw infection should be eliminated before bisphosphonate therapy is initiated in these patients to reduce the necessity of subsequent dentoalveolar surgery. Conservative débridement of necrotic bone, pain control, infection management, use of antimicrobial oral rinses, and withdrawal of bisphosphonates are preferable to aggressive surgical measures for treating this condition. The degree of risk for osteonecrosis in patients taking oral bisphosphonates, such as alendronate, for osteoporosis is uncertain and warrants careful monitoring.

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Section: Oral Complications Of Bisphosphonate Therapymentioning

confidence: 99%

Systematic Review: Bisphosphonates and Osteonecrosis of the Jaws

2006

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“…ONJ is a nonspecific necrotic lesion of bone tissue characterized by a slow progression and by nonspontaneous recovery [11]. The main cause of the development of bone necrosis is generally considered to be radiotherapy in the head and neck area (radio-osteonecrosis) [11,13,14], but other factors, such as mycotic or herpetic infections or necrotizing sialolytic metaplasias, may also be involved [15].…”

Section: Discussionmentioning

confidence: 99%

“…The definition has obviously, over time, become more accurate for these patients, who are subject to repeated bacterial infections associated with varied symptomatology. We used the above widely accepted definition in our study [11].…”

Section: Methodsmentioning

confidence: 99%

Osteonecrosis of the Jaw in Patients with Bone Metastases Treated with Bisphosphonates: A Retrospective Study

et al. 2008

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After completing this course, the reader will be able to:1. Discuss the importance of treating patients with bone metastases using a multidisciplinary approach.2. Explain why bisphosphonates are a fundamental part of bone metastasis treatment.3. Evaluate the main features of ONJ and, in particular, its high risk factor. 4. Describe the importance of ONJ prevention during bisphosphonate treatment.5. Emphasize the importance of interaction among the patient's dentist, surgeon, and oncologist for the management of ONJ.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME Results. The eight patients with ONJ had all been given zoledronic acid, and two had also been treated with pamidronic acid. In four of the patients, ONJ was diagnosed during treatment, while in the remaining four it was diagnosed several months after therapy with bisphosphonates had ended. Six of these patients received local noninvasive treatment, of whom five progressed. Two showed apparent autolimitation of the disease. The remaining two patients underwent surgical resection and currently show no signs of relapse. All eight ONJ patients presented with various concomitant risk factors such as paradontopathy, dental extraction, or spontaneous avulsion. ABSTRACTConclusions. Our results show that ONJ can appear months after interruption of treatment and that a surgical approach can be used in suitable cases. Closer cooperation is needed among specialists to define guidelines for the prevention of ONJ in patients with bone metastases. The Oncologist 2008;13:330 -336

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“…The determination of effects caused by ionizing radiation, using dose for patients with head and neck cancer, in terms of variations in biochemical composition and surface microhardness [22][23][24][25][26][27][28][29][30][31], as a first step as pathophysiology comprehension, will be helpful for reduced or to eliminate inherent radiotherapy complications. Moreover, it could focus on more details from specific issues as dose reduced fractionation protocols and modalities, as long as data obtained from in vitro studies [31][32][33][34][35][36][37][38][39][40].…”

Section: Cutting and Obtaining Blocks Of Dental Enamel And Root Dentinmentioning

confidence: 99%

“…Moreover, it could focus on more details from specific issues as dose reduced fractionation protocols and modalities, as long as data obtained from in vitro studies [31][32][33][34][35][36][37][38][39][40].…”

Section: Cutting and Obtaining Blocks Of Dental Enamel And Root Dentinmentioning

confidence: 99%

ATR-FTIR Assessment of the Biochemical Composition and Micro Hardness of the Hard Tissues of Oral Cavity Submitted to Gamma Irradiation

Paredes¹,

Geraldo²,

Andrade³

2017

J Cancer Sci Ther

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Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients—a report of a thirty year retrospective review

Cited by 425 publications

References 26 publications

Systematic Review: Bisphosphonates and Osteonecrosis of the Jaws

Systematic Review: Bisphosphonates and Osteonecrosis of the Jaws

Osteonecrosis of the Jaw in Patients with Bone Metastases Treated with Bisphosphonates: A Retrospective Study

ATR-FTIR Assessment of the Biochemical Composition and Micro Hardness of the Hard Tissues of Oral Cavity Submitted to Gamma Irradiation

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