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]

In cases presenting early, 30 HBO dives to 2.4 atmospheres for 90 minutes have been advocated. Good responders should continue to a total of 40 dives. [ijps.org]

• Pain

  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]

  As it progresses, patients often develop the trismus, neuropathic pain, and chronic drainage. [ccij-online.org]

  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]

  In addition, patients may complain of fetor oris (also known as halitosis), numbness, or chronic pain. The area may also present swollen or as a fistula. Severe cases include cortical bone fracture and/or an oro-antral communications. [medium.com]

• Fishing

  Jones AS, Fish B, Fenton JE, Husband DJ. The treatment of early laryngeal cancers (T1-T2 N0): surgery or irradiation? Head Neck 2004;26:127-35. [ PUBMED ] [ FULLTEXT ] 4. Sciubba JJ, Goldenberg D. Oral complications of radiotherapy. [ijps.org]

• Intermittent Claudication

  The methyxanthine derivative, pentoxifylline, used in the treatment of intermittent claudication has been used with some success in radiation induced soft tissue injury but its efficacy in ORN is unclear. [16] HBO therapy has been shown to be effective [ijps.org]

• Sputum

  Intraorally, the mucosa may be dry with frothy sputum but these are relatively acute changes following radiotherapy. The patient may have a non-resolving painful mucosal ulcer with evidence of exposed bone or sequestrum [Figure - 1]. [ijps.org]

• Jaw Disease

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

• Delayed Wound Healing

  wound healing within compromised tissue. [6] The cause of osteoradionecrosis is multifactorial and the aim of this paper is to describe causative factors, pathogenesis, preventive measures and treatment options for osteoradionecrosis of the mandible. [ijps.org]

  Bisphosphonates also have antiangiogenic properties which can delay wound healing [Ruggiero et al 2004, Migliorati et al 2006]. Bisphosphonate-associated osteonecrosis can develop spontaneously [Migliorati et al 2006]. [ispub.com]

• Thin Skin

  skin, pigmentary changes, lack of hair and telangiectasis. [ijps.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]

• Periostal Elevation

  If an extraction is performed, avoid using periosteal elevators, irrigate the site with saline, eliminate bony spicules, and try to create primary closure. Fluoridated Toothpaste. [medium.com]

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

Available from: » Introduction The treatment of head and neck cancer remains a challenge. [ijps.org]

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]

However, the defect size gradually increased and the necrosis region grew wider, calling for a different type of treatment. [e-ceo.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]

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

[…] carious and periodontally compromised teeth in the irradiated mandible has often been associated with osteoradionecrosis, the current school of thought is that extractions of grossly carious, periodontally "hopeless," or those teeth deemed to have poor prognosis [utmb.edu]

The current school of thought - grossly carious, periodontally "hopeless," or those teeth deemed to have poor prognosis for retention beyond twelve months should be removed prior to the initiation of radiation therapy - this avoids dental manipulations [slideshare.net]

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]

Keywords Osteoradionecrosis Etiology Pathophysiology Risk factors Treatment options Bisphosphonate osteonecrosis This is a preview of subscription content, log in to check access. References 1. [link.springer.com]

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

Epidemiology Frequency ORN is rare in patients who receive less than 60 gray (Gy) radiation therapy. Patients with ORN who receive less than 60 Gy and more than 50 Gy have been reported, but these cases are extremely rare. [emedicine.medscape.com]

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]

These epidemiologic data show the importance in evaluating bisphosphonate associated morbidity. [ncbi.nlm.nih.gov]

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]

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]

The pathophysiology is still not well understood, yet there are several postulated theories. Probably, the most popular and well-known hypothesis was proposed by Marx in 1983. [medium.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]