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  1. Managing complications of radiation therapy in head and neck cancer patients: Part IV. Management of osteoradionecrosis
    Ramli R, Ngeow WC, Rahman RA, Chai WL
    Singapore Dent J, 2006 Dec;28(1):11-5.
    PMID: 17378336
    Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Pretreatment dental assessment should be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally and, as a result, they succumb to complicated oral adverse effects after radiation therapy. Osteoradionecrosis (ORN) is a severe debilitating condition that impairs healing due to reduction in vascularity and osteocyte population in the affected bone. This article reviews methods of treatment used to treat ORN such as antibiotics, hyperbaric oxygen therapy, therapeutic ultrasound, surgery, and other modalities.
    Matched MeSH terms: Osteoradionecrosis/therapy*
  2. Fulltext Autogenous free fat graft combined with platelet-rich fibrin heals a refractory mandibular osteoradionecrosis
    Law B, Mohd Yunus SS, Ramli R
    Clin Ter, 2020 3 7;171(2):e110-e113.
    PMID: 32141481 DOI: 10.7417/CT.2020.2199
    Osteoradionecrosis (ORN) is a well-recognized, debilitating complication of radiotherapy for patients with head and neck cancer. There is no universally accepted treatment for ORN of the jawbones. We report on a case of refractory mandibular ORN treated by sequestrectomy of mandible and autogenous transplantation of fat graft combined with platelet-rich fibrin (PRF). Improved perfusion was observed using the laser Doppler flowmetry. This case highlights the use of autogenous free fat graft and PRF as an adjunct therapy to sequestrectomy in the management of ORN.
    Matched MeSH terms: Osteoradionecrosis/therapy*
  3. Predictive factors for osteoradionecrosis of the jaws: A retrospective study
    Sathasivam HP, Davies GR, Boyd NM
    Head Neck, 2018 Jan;40(1):46-54.
    PMID: 29149496 DOI: 10.1002/hed.24907
    BACKGROUND: Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.

    METHODS: A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors.

    RESULTS: Fifty-nine patients had ORNJ. Statistical analysis using Cox regression analysis identified several statistically significant variables: dentoalveolar surgery; peri-resective surgery of the jaw; continued tobacco usage after radiotherapy, diabetes mellitus type 2 (DM2); and total radiation dose.

    CONCLUSION: Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.

    Matched MeSH terms: Osteoradionecrosis/therapy
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