Patient and treatment-related risk factors for osteoradionecrosis of the jaw in patients with head and neck cancer

Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity‐modulated radiotherapy

“…Our grading system for ORN is based on the duration of bone exposure and the management required, similar to the grading definitions of Glanzmann and Gratz 3 or Tsai et al 14 However, the decision and timing of ORN-related interventions or treatments were based solely on our institutional experience and expertise. 3,16,19,23 It is important to point out that there may be multiple types of toxicities described as ORN, which have been included in the current analysis. We excluded those individuals with carcinomas of the oral cavity, larynx, and hypopharynx to minimize confounding variables introduced by surgical cancer management.…”

“…10,16 ORN was graded according to the ORN scoring system of the Princess Margaret Cancer Centre (see Supporting Information Table 1) as follows: grade 1 indicates loss of mucosa with exposed bone requiring antibiotic treatment or the need for sequestrectomy for a duration of 3 months; grade 2 indicates loss of mucosa with exposed bone requiring antibiotic treatment or the need for sequestrectomy for a duration of >3 months and 6 months; grade 3 indicates loss of mucosa with exposed bone requiring antibiotic treatment or the need for sequestrectomy for a duration of >6 months, the need for hyperbaric oxygen therapy (HBO), or medical management with pentoxifylline/vitamin E; grade 4 indicates loss of mucosa with exposed bone requiring antibiotic treatment or the need for sequestrectomy for a duration of >12 months, the need for surgery, or pathological bone fracture; and grade 5 indicates death from ORN. These factors included smoking status (former/nonsmoker vs current smoker), use of systemic treatment (no vs yes), IMRT fraction size (2 grays [Gy] vs > 2 Gy), and T classification (T1-3 vs T4).…”

Predictive factors for osteoradionecrosis of the jaws: A retrospective study

“…In this study, most of the ORNJ cases occurred at sites of peri‐resective surgery. Jaw surgery has been thought to predispose patients to development of ORNJ . Such surgery may be performed either to remove a tumor or gain surgical access.…”

Changes in Peri-Implant Bone Level and Effect of Potential Influential Factors on Dental Implants in Irradiated and Nonirradiated Patients Following Multimodal Therapy Due to Head and Neck Cancer: A Retrospective Study

“…36 Unfavorable prosthetic pressure can result in pressure sores and dehiscences followed by septic osteoradionecrosis. [35][36][37][38] In the present study the irradiated patients received bar-retained prostheses or fixed bridges according to individual anatomical and patient-centered parameters. The periimplant bone loss after 3 years was similar regardless of type of prosthesis.…”