Osteoradionecrosis

Osteoradionecrosis is a severe and devastating late complication of radiotherapy in patients with head and neck cancer. The diagnosis of Osteoradionecrosis is established by clinical and radiographic evidence of bone necrosis after irradiation. Especially in the mandible, since it has high density and low blood vasculature. Typically it is defined as osteonecrosis caused by ionizing radiation. Clinically it is the loss of skin or mucosal tissue and exposure of necrotic bone tissue for at least three months in a previously irradiated area without evidence of residual or recurrent tumor. Progression of the condition may lead to pathologic fracture, intraoral and/or extraoral fistula formation, bone sequestration, trismus, pain, local or systemic infection and sometimes permanent deformity. Other symptoms include dysesthesia, halitosis, dysgeusia and food impaction. The diagnosis of ORN is established by clinical and radiographic evidence of bone necrosis after irradiation, which is not related to tumor recurrence. Most cases of ORN occur in the first years after radiotherapy, and they include almost all cases that developed spontaneously; however, the trauma-induced ORN may develop years after initial therapy. Pathological Fracture of the Mandible Associated to Osteoradionecrosis with Necrotic Bone and Reconstruction Plate Exposure: Case Report: Stramandinoli-Zanicotti RT, Silva WPP, Schussel JL, Dissenha JL and Sassi LM

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Last date updated on July, 2025