Proposal for a new staging system for osteoradionecrosis of the mandible

Karagozoglu, K.H.; Dekker, Hannah; Rietveld, D.; Bree, Remco de; Schulten, E.A.J.M.; Kantola, Saara; Forouzanfar, Tymour; Waal, I. van der

doi:10.4317/medoral.19623

Cited by 15 publications

(14 citation statements)

References 10 publications

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“… Stage 0: mucosal defects only; bone exposed  Stage I: radiological evidence of necrotic bone, dento-alveolar only  Stage II: positive radiographic findings above ID canal with denuded bone intraorally  Stage III: clinically exposed radionecrotic bone, verified by imaging techniques, along with skin fistulas and infection with addition of potential or actual pathological fracture. Radiological evidence of bone necrosis within the radiation field, where tumour recurrence has been excluded (Dhanda et al, 2016) (Deshpande et al, 2015 (Karagozoglu, et al. 2014) (Shaw and Dhanda, 2011) (Notani, et al.…”

Section: Osteoradionecrosismentioning

confidence: 99%

The oral management of oncology patients requiring radiotherapy, chemotherapy and/or bone marrow transplantation

Kumar

Brooke

Burke

et al. 2013

FDJ

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Patients undergoing cancer therapy may experience unwanted side-effects involving the oral cavity and more evidence is emerging regarding the management of these complications. These oral effects have both short and long-term implications. Dentists need to be aware of these implications and liaise closely with the oncology teams to establish pathways of oral care. This enables patients to have appropriate dental support in place before, during and after cancer therapy. This article is an executive summary of a review undertaken for a national clinical guideline, The Oral Management of Oncology Patients following Radiotherapy, Chemotherapy and/or Bone Marrow Transplanation. The full text is available on the FDS website: www.rcseng.ac.uk/fds/publications-clinical-guidelines/clinical_guidelines/

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Section: Osteoradionecrosismentioning

confidence: 99%

The oral management of oncology patients requiring radiotherapy, chemotherapy and/or bone marrow transplantation

Kumar

Brooke

Burke

et al. 2013

FDJ

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“…Despite being an entity well known by health professionals who deal with the treatment of head and neck cancer, ORN presents many controversies. From its classification to its best therapeutic (He, et al, 2015;Lyons, et al, 2014;Karagozoglu, et al, 2014). For initial lesions, conservative management can be used.…”

Section: Resultsmentioning

confidence: 99%

Challenges of an unusual Osteoradionecrosis of the jaws: case report

Sousa

Cerqueira

Pimentel³

et al. 2021

RSD

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Osteoradionecrosis (ORN) is the most worrying radiotherapy late complication. It is a condition in which the irradiated bone becomes devitalized and exposed through fistulas in the skin or mucosa. It remains without healing for a period of at least three months. Despite being a well-known entity to the professionals who treat neoplasms of the head and neck, the disease has many controversies. From its classifications to its best treatment plan. Its main signs and symptoms are pain, drainage of secretion, fistulas, ulcers of the oral mucosa, bone exposure, bone necrosis, and the surrounding soft tissue. This study aims to report a clinical case of a patient with ORN in the jaw treated at Bahiana School of Medicine and Public Health and the General Roberto Santos Hospital. A 60-year-old-male patient with a malignant neoplasm in the tonsil region, was diagnosed with ORN in mandible region, three years after radiotherapy. The treatment proposal was conservative (ozone therapy, hyperbaric oxygen and chlorexidine mouth rinse) associated with surgical debridement, with good results that involved the patient’s rehabilitation. It is concluded that the association of conservative therapies with surgery demonstrated satisfactory results and improving the quality of life of cancer patients with ORN.

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“…However, the clinical characteristics relevant to the original disease were not included in this system, in addition to losing their efficiency of classification when the anti-fibrotic tissue factor is removed. Whereas in the staging elaborated by Karazoglu et al 10 , the approach was more extensive and is based on a combination of clinical and radiological findings, symptoms, and presence or absence of oral and/or cutaneous fistulas in patients with ORN located in the mandibular region (Table 5).…”

Section: Systems Of Evaluation Of Ornmentioning

confidence: 99%

“…The prevention of this condition should be a priority in the dental team through the elimination of possible infectious foci before starting the locoregional radiotherapy. In cases of necessity of traumatic dental procedures after radiotherapy, procedures must be used that aim to minimize this risk 10 .…”

Section: Introductionmentioning

confidence: 99%

New Therapeutic Approaches to Osteoradionecrosis: Literature Review

Dantas

Reis

2019

J. Health Scie.

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Radiotherapy is an important treatment of oral and maxillofacial malignancies. Among the various effects of this locoregional therapy, osteoradionecrosis (ORN) plays a prominent role due to its physical and psychological impact on cancer patients. In the literature, the therapeutic approach of ORN varies from a conservative to invasive surgery treatment. Objective: collect in the scientific literature, concise and current information about the benefits of using these therapies in the ORN. The present literature review selected articles based on the titles that addressed osteoradionecrosis treatment, as well as the evaluation systems adopted. After previous analysis, 22 relevant articles were included on the proposed theme. According to the literature, several hypotheses have been established to explain the etiopathogenesis of ORN, as numerous evaluation systems have been developed in the last years. Regarding the main therapeutic modalities used, new less invasive therapies have acquired space, such as ozone therapy, laser therapy associated with photodynamic therapy and drugs, such as vitamin, antifibrotic and anti-resorptive. However, in spite of the promising results, new randomized clinical trials have to be performed in an attempt to discover the real effectiveness of these therapies in the ORN. Therefore, it becomes a challenging issue for dental surgeons, since it requires the constant monitoring and long term of these patients, due to the risk of progression or recurrence of this condition.Keywords: Radiotherapy. Osteoradionecrosis. Conservative Treatment. Ozone. Photochemotherapy.ResumoA radioterapia compreende um tratamento importante no tratamento de tumores malignos orais e maxilofaciais. Dentre os diversos efeitos oriundos desta terapia locoregional, a osteorradionecrose (ORN) apresenta um papel de destaque devido ao seu impacto físico e psicológico ao paciente oncológico. A abordagem terapêutica da ORN pode variar do tratamento conservador ao tratamento invasivo através da cirurgia. Objetivo coletar na literatura científica informações concisas e atuais acerca dos benefícos do uso dessas terapias na ORN. A presente revisão narrativa de literatura teve a seleção de artigos com base nos títulos que abordaram as terapias empregadas na osteorradionecrose, bem como os sistemas de avaliação adotados. Após análise prévia, foram incluídos 39 artigos relevantes sobre a temática proposta. De acordo com a literatura, várias hipóteses foram estabelecidas para explicar a etiopatogenia da ORN, assim como inúmeros sistemas de avaliação foram desenvolvidos nos últimos anos. Com relação as principais modalidades terapêuticas empregadas, novas terapias menos invasivas têm adquirido espaço, a exemplo da ozonioterapia, laserterapia associada à terapia fotodinâmica e medicamentos antioxidantes, antifibróticos e antireabsortivos. Todavia, apesar dos resultados promissores, novos ensaios clínicos precisam ser realizados, para se descobrir a real eficácia dessas terapias na ORN. Portanto, torna-se uma questão desafiadora para os Cirurgiões dentistas, uma vez que requer o monitoramento constante e a longo prazo desses pacientes, devido ao risco de progressão ou recidiva desta afecção.Palavras-chave: Radioterapia. Osteoradionecrosis. Tratamento Conservador. Ozônio. Fotoquimioterapia.

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Proposal for a new staging system for osteoradionecrosis of the mandible

Cited by 15 publications

References 10 publications

The oral management of oncology patients requiring radiotherapy, chemotherapy and/or bone marrow transplantation

The oral management of oncology patients requiring radiotherapy, chemotherapy and/or bone marrow transplantation

Challenges of an unusual Osteoradionecrosis of the jaws: case report

New Therapeutic Approaches to Osteoradionecrosis: Literature Review

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