Bilateral Osteoradionecrosis of Mandible: A Case Report
Osteoradionecrosis (ORN) defines exposed irradiated bone, which fails to heal over a period of 3–6 months without evidence of residual or recurrent tumor. It is a long term and serious complication of therapeutic radiotherapy for head and neck cancer. The pathogenesis of ORN has been proposed relating it to a fibroatrophic mechanism including free radical formation, endothelial dysfunction, inflammation, microvascular thrombosis leading to bone and tissue necrosis. Risk factors mainly include radiation related risk factors, surgery, tobacco and alcohol abuse. Removing of diseased teeth after radiotherapy is generally considered the main risk factor in ORN. Prevention of ORN is based on the preventive extractions of decayed or periodontally compromised teeth before radiotherapy. Based on the clinical staging various therapeutic protocols have been suggested. We here report a case of Bilateral mandibular ORN with discussion of clinical features, pathogenesis, preventive measures, and management of ORN.