Abstract
Osteoradionecrosis (ORN) of the mandible is a severe complication associated with head and neck radiotherapy ; however, prevention and treatment of ORN is a still controversial problem. ORN is characterized by a hypovascular, hypoxic, and hypocellular condition resulting in tissue breakdown and bone necrosis. Evaluation of the bone viability is important to treat ORN.
Conservative treatments combined with hyperbaric oxygen therapy should be done initially. In persistent or progressive cases against these treatments, radical resection of the necrotic mandible is indicated. Irradiated mandibles had poor potential of bone viability, therefore, the periosteal blood supply should be conserved and surgical interventions must be minimized to avoid recurrence of ORN.
To prevent ORN, educational motivation of the patient by a radiation oncologist is necessary. Professional oral management, such as spacer, mechanical oral cleaning and topical fluoride application, should be useful to avoid radiation-induced complications.
