CONCLUSIONS: The present study is the first report comparing the incidence of osteoradionecrosis between superselective intra-arterial chemoradiotherapy and intravenous chemoradiotherapy. [ncbi.nlm.nih.gov]

[…] front teeth present the lowest risk. [medium.com]

She presented 7 months later with bone exposed mesial to tooth #43. [pmhdentaloncology.ca]

• Pain

  Back and neck pain are among the most common conditions people suffer from. For some, back and neck pain is an annoyance or inconvenience; for others, it can be debilitating. [northwell.edu]

  One month after the surgical procedure, the patient responded satisfactorily to the treatment, showing significant improvement in speech and oral food intake, as well as significant decrease in lingual pain. [ncbi.nlm.nih.gov]

  You may experience pain, swelling and malocclusion (misalignment of the teeth). For diagnosis and treatment of this condition, seek the oral and maxillofacial surgeons at Jefferson. [hospitals.jefferson.edu]

  Forcing my jaw open beyond a certain pain causes pain. Has anyone experienced this problem and how was it treated? George Hi George. [cancercompass.com]

  To start with, I had little pain in the beginning and none once the nerve was damaged. The jaw fracture seemed to just happen, but did not break all the way. No pain then either. [community.macmillan.org.uk]

• Weakness

  The jaw bones can become exposed in the mouth or through the facial skin and the weakness may even lead to jaw fracture. [ucsfhealth.org]

  Marx, et. al. states that the overall weakness inherent in non-surgical approaches is that significant amounts of necrotic tissue significantly impairs adequate wound healing.[47] It has been his clinical experience and several others that most wounds [utmb.edu]

  They concluded, based on weak evidence, that prophylactic HBO therapy was effective in reducing the risk of developing ORN after post‐radiation extractions. [cochranelibrary.com]

• Falling

  […] oro-cutaneous fistula, or radiographic evidence of bony resorption of the lower border of the mandible are immediately classified as Stage III disease, bypassing the protocol for Stages I and II disease. [6] According to this system, cases 1 and 2 would fall [ccij-online.org]

  Only a minority of patients goes on to develop osteoradionecrosis following radiotherapy and this number is thought to be falling. This, in part, is due to our better understanding of the etiology of the condition and a multidisciplinary approach. [ijps.org]

• Periodontitis

  Among these, oral and oropharyngeal cancer, periapical periodontitis, and tooth extraction after radiotherapy were significant independent risk factors by multivariate analysis. [ncbi.nlm.nih.gov]

  In the matched case-control analysis the significant risk factors on univariate analysis were poor periodontal status, history of alcohol use and radiation dose (P = 0.03, 0.002 and 0.009, respectively) and on multivariate analysis were alcohol use and [synapse.mskcc.org]

  The radiograph revealed irregular periodontal ligament space widening. Periapical rarefying osteitis would be centred around the apices of the tooth and periodontal bone loss would be originating at the alveolar crest. [pmhdentaloncology.ca]

  This includes the following: (1) dentate patients—full series of dental radiographs and a panoramic radiograph (2) edentulous patients—a panoramic radiograph and problem-focused intraoral radiographs (3) periodontal evaluation and control of periodontal [dentistrytoday.com]

  […] diseases Acute necrotizing ulcerative gingivitis Pericoronitis Peri-implantitis Periodontal abscess Periodontal trauma Periodontitis Aggressive As a manifestation of systemic disease Chronic Perio-endo lesion Teething Periapical, mandibular and maxillary [en.wikipedia.org]

• Jaw Disease

  2012 ICD-9-CM Diagnosis Code 526.89 Other specified diseases of the jaws Short description: Jaw disease NEC. [icd9data.com]

• Tooth Loss

  […] syndrome Vertical root fracture Occlusal Tooth loss Edentulism Tooth wear Abrasion Abfraction Acid erosion Attrition Periodontium ( gingiva, periodontal ligament, cementum, alveolus ) – Gums and tooth-supporting structures Cementicle Cementoblastoma [en.wikipedia.org]

• Fracture

  A pathologic fracture was evident on examination. Biopsies were negative for carcinoma. This is the panoramic radiograph of the patient seen in the image above. Bone necrosis and pathologic fracture are evident. [emedicine.medscape.com]

  An ankle fracture occurs when one or more than one bone that makes up the ankle joint—and possibly its ligaments—breaks at or near the joint. Every year, 184 people out of every 100,000 sustain ankle fractures. [northwell.edu]

  There is the risk of a pathologic fracture. [pmhdentaloncology.ca]

  Stage I – Resolved healed osteonecrosis (A) – No pathologic fracture (B) – Pathologic fracture Stage II – Chronic persistent and non-progressive osteonecrosis (A) – No pathologic fracture (B) – Pathologic fracture Stage III – Active progressive osteonecrosis [slideshare.net]

  […] orocutaneous fistula, osteolytic involvement of inferior border) Schwartz et al: Stage I:small area of limited exposed cortical bone Stage II: exposed cortical and underlying medullary bone necrotic Stage III: full thickness necrosis, +/- pathologic fracture [pathologyoutlines.com]

• Osteoporosis

  […] en Osteonecrosis of the jaw has also been reported in patients with osteoporosis receiving oral bisphosphonates it E ' nei guai fino al collo.Pensavo fosse entrata ma aveva allungato il braccio per prendere la cintura di sicurezza e... [it.glosbe.com]

  She was being treated for osteoporosis with Actonel and hypertension with Norvasc. Her dentist extracted the lower right molar in 2009 after which she sustained a pathologic fracture. [pmhdentaloncology.ca]

  Studies have looked at the benefits and risks of these treatments for post menopausal women with early breast cancer who have bisphosphonates to lower their risk of cancer coming back and to prevent osteoporosis. [cancerresearchuk.org]

  Failure of osseointegrated dental implants after diphosphonate therapy for osteoporosis: a case report. Int J Oral Maxillofac Implants 1995;10:74-8. [piper.espacio-seram.com]

  "Bisphosphonates for the prevention and treatment of osteoporosis". BMJ. 351 : h3783. doi : 10.1136/bmj.h3783. PMID 26333528. ^ Turner AJ, Hick PE (September 1975). "Inhibition of aldehyde reductase by acidic metabolites of the biogenic amines". [en.wikipedia.org]

• Bone Disorder

  Inhibitor RANK-L, for example Denosumab, is usually used to treat bone disorders such as osteoporosis. [23] Examples of antiangiogenic agents include: Bevacizumab This is a monoclonal antibody that inhibits vascular endothelial growth factor (VEGF) which [en.wikipedia.org]

• Irritability

  In most cases, tissue injury caused by tooth extraction, oral surgery or irritation from dentures cause the development of ORN. Rarely, ORN develops without an inciting factor, a condition known as spontaneous ORN. [woundcarecenters.org]

  To most authors, antibiotics, oral rinses, and irritant avoidance is simply not clinically effective. [utmb.edu]

  Bone injury can occur through direct trauma (eg, tooth extraction [84%], related cancer surgery or biopsy [12%], denture irritation [1%]) or by exposure of the irradiated bone to the hostile environment of the oral cavity secondary to overlying soft tissue [emedicine.medscape.com]

  The exposed bony edges were sharp causing irritation to adjacent soft tissues. Pathophysiology ORN has a known predilection for the mandible over maxilla [26]. [frontiersin.org]

  Bone injury can occur through direct trauma - 1. tooth extraction [84%], 2. related cancer surgery or biopsy [12%], 3. denture irritation [1%]) or 4. by exposure of the oral cavity to the environment secondary to overlying soft tissue necrosis. [slideshare.net]

It has been used successfully in the treatment of delayed radiation injury for over 30 for years. Hyperbaric oxygen treatment allows more oxygen to reach these radiation damaged areas. [longbeachhyperbaricmedicine.com]

Ozone therapy is given as an option in the therapeutic protocol for the prevention and treatment of ORN. [ncbi.nlm.nih.gov]

The present paper provides a literature review and update on the risk factors underlying osteoradionecrosis, its clinical and diagnostic particulars, prevention and most widely accepted treatment options including the latest treatment modalities. [link.springer.com]

Recently, new concepts have been introduced regarding the pathogenesis of osteoradionecrosis, and these ideas help outline new guidelines for treatment. [journals.lww.com]

[…] sclerotic-lucent pattern sequestration, especially of the buccal bone an absence of soft tissue mass is an important feature to differentiate it from neoplastic recurrence but the presence of soft tissue does not exclude osteoradionecrosis Treatment and prognosis [radiopaedia.org]

Teeth in the RT field were usually extracted if thought to have poor long-term prognosis from dental disease. [scinapse.io]

Knowledge of radiation dose, treatment modality, field of radiation, and tumor prognosis play an important role in the clinical decision-making. [frontiersin.org]

Teeth with questionable prognosis should be carefully discussed with the patient. [6], [13], [14] Hygiene during radiotherapy : During radiotherapy, the patient will experience mucositis and xerostomia. [ijps.org]

Management of ORN from a dental perspective aims at preventing the development of ORN with thorough pre radiation therapy assessment of the patient, wherein all teeth with deep carious lesions or a hopeless periodontal prognosis are extracted. [ccij-online.org]

[…] due to the underlying etiology. [icd10data.com]

This, in part, is due to our better understanding of the etiology of the condition and a multidisciplinary approach. [ijps.org]

Etiology ORN can be either spontaneous or the result of an insult. Spontaneous ORN occurs when, in the process of otherwise normal turnover of bone, the degradative function exceeds new bone production. [emedicine.medscape.com]

[…] en Osteonecrosis : although the etiology is considered to be multifactorial (including corticosteroid use, alcohol consumption, severe immunosuppression, higher body mass index), cases of osteonecrosis have been reported particularly in patients with [it.glosbe.com]

Osteoradionecrosis of the mandible: etiology, prevention, diagnosis and treatment. Indian J Plast Surg 2007 ; 40 : 65 – 71 3. ↵ Bras J, de Jonge HK, van Merkesteyn JP. Osteoradionecrosis of the mandible: pathogenesis. [ajnr.org]

Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review. Int. Dent. J. 2018; 68 (1): 22-30. Epstein J, Wong F, SMP. [revoncologia.sld.cu]

In an effort to clarify the current frequency of and risk factors for ORNJ, Beadle and colleagues reviewed data from the NCI Surveillance, Epidemiology, and End Results database, linked to Medicare claims records. [medpagetoday.com]

EPIDEMIOLOGY Maxillofacial osteonecrosis has been microscopically confirmed in patients as young as 12 years of age and as old as 94, and has been reported in both genders.Typically, however, more than 80% of patients are 35-55 years of age and an equal [flipper.diff.org]

Methods The Surveillance, Epidemiology, and End Results (SEER)–Medicare database was used to identify patients treated with RT for oral cancers from 1999 to 2007. [scinapse.io]

With a change in the concept in the pathophysiology of osteoradionecrosis, the treatment of the disease has also undergone significant revision. [utmb.edu]

Lyons A, Ghazali N (2008) Osteoradionecrosis of the jaws: current understanding of its pathophysiology and treatment. Br J Oral Maxillofac Surg 46:653–660 CrossRef PubMed Google Scholar 2. [link.springer.com]

Hardcover: 900 pages Publisher: Quintessence Publishing (IL); Slipcase edition (November 1, 2002) ***2) Osteoradionecrosis: A new concept of its pathophysiology Marx RE, Journal of Oral and Maxillofacial Surgery, May 1983 (Vol. 41, Issue 5, Pages 283- [osseonews.com]

Early theories on ORN held that three factors—radiation, trauma, and infection—contributed to the pathophysiology of this disease process. [e-ceo.org]

Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg. 1983 May. 41(5):283-8. [Medline]. Marx RE. A new concept in the treatment of osteoradionecrosis. J Oral Maxillofac Surg. 1983 Jun. 41(6):351-7. [Medline]. [emedicine.medscape.com]

KEYWORDS: Hyperbaric oxygen; Management; Osteoradionecrosis; Prevention [ncbi.nlm.nih.gov]

Prevention and treatment. Eur Arch Otorhinolaryngol 2001;258:481-7. 13. Sulaiman F, Huryn JM, Zlotolow IM. [ijps.org]

No widely-accepted, evidence-based guidelines for the use of HBO therapy in the prevention and management of ORN have been established. [e-ceo.org]

[…] evaluate these preventive options. [cochranelibrary.com]