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Osteoradionecrosis (ORN) also known as postradiation osteonecrosis (PRON), is a serious, debilitating and deforming potential complication of radiation therapy for the treatment of cancer of the head and neck. It has been defined as a necrosis or death of the bone of the mandible or maxilla that may occur following radiation therapy for cancer in the oral and perioral region. It is known to occur when bone, in this case the mandible and/or maxilla, are directly in the field of radiation. The reported incidence ranges from 2.6% to 22% but most commonly considered to be around 10% +/- 5%. Although it usually occurs in the mandible it can occur in the maxilla and it can occur following brachytherapy (radiation implants).


Original Author:  Daniel E. Jolly, DDS, FAAHD, FACD, DABSCD,is in private practice in Columbus, Ohio. He is retired as Professor and Director of the General Practice Residency program at The Ohio State University College of Dentistry and University Medical Center. He has actively practiced dental care for people with cancer for over 30 years and educated the dental team over those same three decades. Dr. Jolly is a Fellow in the American Association of Hospital Dentists and the American College of Dentists. He also is a Diplomate of the American Board of Special Care Dentistry and has served as President of the American Association of Hospital Dentists and the Special Care Dentistry Association.

Review and Revision:  Christina L. Ross, CDA, EFDA, MS
Associate Professor and Dental Assisting Program Chair; Interim Dean of Health Sciences, Ivy Tech Community College, Columbus, IN


Upon completion of this course, the dental professional should be able to:
• Define Osteoradionecrosis (ORN).
• Explain the development of Osteoradionecrosis (ORN).
• Identify the signs and symptoms of Osteoradionecrosis (ORN).
• Describe how radiation affects the vascularity of the bone.
• List five preventive measures taken to prevent Osteoradionecrosis (ORN).
• Explain what role Hyperbaric Oxygen plays as both a prevention and treatment modality.
• Explain what Hyperbaric Oxygen is and how it benefits patients with Osteoradionecrosis (ORN).


The ADAA has an obligation to disseminate knowledge in the field of dentistry.  Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.

The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.

Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.


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