Osteoradionecrosis of the Mandible: Treatment Outcomes and Factors Influencing the Progress of Osteoradionecrosis

Oh, Hee-Kyun; Chambers, Mark S.; Martin, Jack W.; Lim, Hoi Jeong; Park, Hong Ju

doi:10.1016/j.joms.2009.02.008

Cited by 97 publications

(86 citation statements)

References 17 publications

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“…The management of ONR remains a difficult and challenging problem 11 . Several therapies have been investigated for the treatment of ORN, with varying .…”

Section: Case Reportmentioning

confidence: 99%

“…The dysregulation of fibroblastic activity in irradiate area produces atrophic tissue with damage to microvessels, and allows increased leakage of inflammatory mediators 14 . The mandible is one of the most frequently affected bones 2,6,11,[17][18][19] . ORN has been reported as the major complication of irradiation in head and neck cancer 2,[5][6][7]11,13,[20][21][22] .…”

Section: Case Reportmentioning

confidence: 99%

“…According to Kluth et al 23 ORN can occur through a combination of factors such as tumor site, extraction site, denture irritation, and/or surgery. Oh et al 11 reported that 43% of ORN cases occurred spontaneously or through unknown causes.…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Successful in a conservative treatment of osteoradionecrosis of the jaw: a case report and review of literature

Moraes

Thomaz

Silva

et al. 2016

RGO, Rev. Gaúch. Odontol.

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Osteoradionecrosis of jaws is one of the most serious complications of radiation therapy for head and neck malignancies. RESUMOOsteorradionecrose dos maxilares é uma das complicações mais sérias da radioterapia para o tratamento de tumores de cabeça e pescoço. O manejo da osteorradionecrose continua sendo discutido e há poucos relatos de casos descrevendo modalidades de tratamento conservadoras. Este artigo apresenta um caso de osteorradionecrose na mandíbula de um paciente de 58 anos de idade, após a realização de exodontia e explora uma modalidade de tratamento conservador com um follow-up de três anos. Foram combinadas antibioticoterapia e irrigação diária utlizando clorexidina. Após três anos é possível observar a resolução do caso em imagens de tomografia computadorizada de feixe cônico e reconstruções 3D. As imagens evidenciam remodelação óssea após este período de acompanhamento e sem a presença de osso exposto. Pode-se concluir que a terapia proposta resultou em sucesso e o paciente continua em acompanhamento periódico.

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“…The management of ONR remains a difficult and challenging problem 11 . Several therapies have been investigated for the treatment of ORN, with varying .…”

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Successful in a conservative treatment of osteoradionecrosis of the jaw: a case report and review of literature

Moraes

Thomaz

Silva

et al. 2016

RGO, Rev. Gaúch. Odontol.

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“…La incidencia de la ORN en pacientes dentados es tres veces mayor que en pacientes desdentados, debido a la presencia de raíces residuales, enfermedad periodontal y falta de higiene oral (Bennett et al, 2005). Algunos estudios también informan de que la mandíbula se ve más afectada que el maxilar, ya que se encuentra en un campo de radiación más alta y su suministro sanguíneo es menor (Lyons & Ghazali, 2008;Oh et al, 2009). …”

Section: Discussionunclassified

Fractura Patológica por Osteorradionecrosis de Mandíbula: Relato de Caso

Rui

Rettore

Bona

et al. 2014

Int. J. Odontostomat.

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El carcinoma de células escamosas (CEC) representa el 90% a 95% de las neoplasias malignas de la cavidad oral, sobre todo los localizados en la lengua, especialmente en el margen lateral posterior. Por lo general, afecta a hombres mayores de 50 años, la mayoría con antecedentes de alto consumo de tabaco y alcohol (Rocha et al., 2008;Sundaram et al., 2005) Carcinoma de células escamosas de la cavidad oral y orofaringe es poco frecuente en los pacientes menores de 45 años y suele presentarse en pacientes hombres entre la 6 ª y la 7ª década de la vida. En este grupo, la influencia real de un agente carcinógeno es ampliamente debatida, sobre todo en relación al consumo de tabaco y alcohol. Se sabe que estas sustancias son carcinógenos en pacientes de edad avanzada, también puede estar relacionado con la etiología de CEC en los jóvenes. Junto a esto, el bajo nivel educativo y grupo socioeconómico también se propone como factores de riesgo (Rocha et al.;Sundaram et al.;Llewellyn et al., 2004).Es probable que se requiera más de un factor para producir la malignidad. Los factores extrínsecos tales como el tabaquismo, el alcohol, la luz solar y los factores intrínse-cos incluyen la desnutrición, la anemia y la herencia, incluso son los más citados (Chrcanovic et al., 2010). Además, en la actualidad se discute la presencia del virus papiloma humano (VPH) como un factor etiológico de CEC (Díaz-Molina et al., 2012) La elección del tratamiento depende del grado y del progreso de la enfermedad e independiente de la etiología. En la fase inicial (I y II), llevando a cabo cualquier tipo de terapia, todos los casos dan buenos resultados. En casos de carcinoma en estadios avanzados (III y IV) el pronóstico es menor y se requiere una combinación de técni-cas terapéuticas como la cirugía complementada con radioterapia y quimioterapia (Díaz-Molina et al.) Osteorradionecrosis se define como un área expuesta de hueso necrótico en una o más ubicaciones de maxilar o mandíbula que no se regenera después de 3 meses de tra- RESUMEN:La radioterapia es un tratamiento efectivo contra el cáncer, pero produce cambios en los tejidos adyacentes a las áreas irradiadas. En el hueso, la irradiación provoca hipoxia, hipocelularidad e hipovascularidad, haciendo que el tejido no sea capaz de regenerarse. Se presenta un caso de osteorradionecrosis ocurrido a causa de una extracción dental después de la radioterapia. Un hombre de 41 años con carcinoma epidermoide invasivo moderadamente diferenciado con sitio primario ubicado en suelo de boca en estado T4N2M0, fue sometido a radioterapia y quimioterapia. Después de 39 sesiones de radioterapia con 70 Gy, comenzó a quejarse de dolor en el diente en la mandíbula izquierda, que fue extraído por un dentista cirujano. Un mes después de la extracción, el paciente fue ingresado en el Hospital de la ciudad de Passo Fundo/RS, Brasil, con un absceso parafaringeo. El paciente diagnosticado con osteorradionecrosis fue tratado mediante cirugía para eliminar el secuestro óseo y lavado de los tejidos para el tratamie...

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“…[8] In the formation of osteonecrosis, long-term use of the drug, advanced age, poor oral hygiene are the most important risk factors, and drug-related osteonecrosis can develop spontaneously. [9,10] During formation of osteonecrosis biphosphonates induce obliteration of regional blood vessels, and consequently avascular bone necrosis occurs. [9] Turkish Journal of Urology 2015; 41 (1) We will present a patient who developed osteonecrosis, and entered into a phase of spontaneous remission whose mucosal integrity was achieved under conservative treatment without the need for additional treatment.…”

Section: Introductionmentioning

confidence: 99%

Mandibular osteonecrosis due to bisphosphonate use

Salvarci

Altınay

2015

Turkish Journal of Urology

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Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3 rd generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture.

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Osteoradionecrosis of the Mandible: Treatment Outcomes and Factors Influencing the Progress of Osteoradionecrosis

Cited by 97 publications

References 17 publications

Successful in a conservative treatment of osteoradionecrosis of the jaw: a case report and review of literature

Successful in a conservative treatment of osteoradionecrosis of the jaw: a case report and review of literature

Fractura Patológica por Osteorradionecrosis de Mandíbula: Relato de Caso

Mandibular osteonecrosis due to bisphosphonate use

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