Osteoradionecrosis of the jaws: Clinical characteristics and relation to the field of irradiation

Thorn, Jens Jørgen; Hansen, Hanne Sand; Specht, Lena; Bastholt, Lars

doi:10.1053/joms.2000.9562

Cited by 259 publications

(265 citation statements)

References 18 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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“…Later, Marx (1983a,b) suggested that the underlying problem in osteoradionecrosis is a compromised wound-healing rather than an infection. Furthermore, osteoradionecrosis is as much a disease process of the covering soft tissues as that of the underlying bone (Epstein et al, 1987a(Epstein et al, ,b, 1997Constantino et al, 1995;Curi and Dib, 1997;Thorn et al, 2000). According to Marx (1983a,b), the sequence in the development of osteoradionecrosis is:…”

Section: Bonementioning

confidence: 99%

Oral Sequelae of Head and Neck Radiotherapy

Vissink

Jansma

Spijkervet

et al. 2003

Critical Reviews in Oral Biology & Medicine

759

512

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In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.

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“…Osteoradionecrosis (ORN) is a bone ischemic necrosis caused by radiation, being one of the most serious consequences of radiotherapy, causing pain as well as possible substantial loss of bone structure 5,28 Due to anticancer therapy, bone cells and the vascularization of bone tissue may suffer irreversible injuries. 26 ORN may occur spontaneously or more commonly, after trauma (generally dental extractions).…”

Section: Osteoradionecrosismentioning

confidence: 99%

Complicações bucais da radioterapia em cabeça e pescoço

Jham

Freire

2006

Rev. Bras. Otorrinolaringol.

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A radioterapia é uma forma terapêutica amplamente utilizada para o tratamento das neoplasias malignas da cabeça e pescoço. Porém, altas doses de radiação em extensos campos que irão incluir a cavidade bucal, maxila, mandíbula e glândulas salivares freqüentemente resultam em diversas reações indesejadas. Dentre as complicações da radioterapia estão a mucosite, candidose, disgeusia, cárie por radiação, osteorradionecrose, necrose do tecido mole e xerostomia. OBJETIVO: O objetivo deste artigo é fazer uma breve revisão das reações adversas que podem ser detectadas durante o tratamento radioterápico em região de cabeça e pescoço. MÉTODO: A literatura pertinente que trata do assunto foi revisada. FORMA DE ESTUDO: Revisão de literatura. RESULTADOS: A radioterapia ainda está associada a diversas reações adversas, que afetam de forma significativa a qualidade de vida dos pacientes. CONCLUSÕES: O tratamento multidisciplinar, incluindo a equipe médica, o cirurgião-dentista, o fonoaudiólogo, o nutricionista e o psicólogo é a melhor alternativa para minimizar ou mesmo prevenir tais complicações.

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Osteoradionecrosis of the jaws: Clinical characteristics and relation to the field of irradiation

Cited by 259 publications

References 18 publications

Systematic Review: Bisphosphonates and Osteonecrosis of the Jaws

Systematic Review: Bisphosphonates and Osteonecrosis of the Jaws

Oral Sequelae of Head and Neck Radiotherapy

Complicações bucais da radioterapia em cabeça e pescoço

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