0908 - Osteoradionecrosis: Oral Health and Dental Treatment
Author/Editor: Original Author: Daniel E. Jolly, DDS, FAAHD, FACD, DABSCD; Review and Revision by Christina L. Ross, CDA, EFDA, MS
Osteoradionecrosis (ORN) of the jaws is most commonly defined clinically as an area of previously irradiated, devitalized, exposed bone that fails to heal over a period of three to six months, in the absence of local neoplastic disease. It is thought to be caused by radiation-induced fibro-atrophic tissue injury. 1 ORN is associated with considerable morbidity and has important ramifications for the quality of life of cancer survivors. 2, 3 Principal manifestations include pain, and, more rarely, dysesthesia and anesthesia. 4 These may be further complicated by secondary infection and fistula formation, as well as dysgeusia, dysphagia, dyspnea, xerostomia, pathologic fracture and mechanical impairment of speech. 4 Many classification systems have been devised in order to stratify the wide spectrum of clinical presentations of ORN; however, their adoption has been far from universal and none has been validated with large-scale clinical trials, 5 posing difficulties for the comparison of controlled interventions and potential disparities in reporting rates.
CE Credits: 2
Original Release Date: 2009; Review Date: 2022; Next Review: 2025