J Korean Assoc Oral Maxillofac Surg 2019; 45(1): 21~28
Retrospective study of osteoradionecrosis in the jaws of patients with head and neck cancer
Brena Rodrigues Manzano, Natália Garcia Santaella, Marco Aurélio Oliveira, Cássia Maria Fischer Rubira, Paulo Sérgio da Silva Santos
Departament of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
Paulo Sérgio da Silva Santos
Departament of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru 17012-901, São Paulo, Brazil
TEL: +55-14-3226-6113 FAX: +55-14-3235-8258
E-mail: paulosss@fob.usp.br
ORCID: https://orcid.org/0000-0002-0674-3759
Received January 31, 2018; Revised June 5, 2018; Accepted June 8, 2018.; Published online February 28, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center.
Materials and Methods: A retrospective descriptive study was performed to analyze dental records from HNC patients with ORN treated at an oncological clinical research center from 2013 to 2017. A total of 158 dental records for HNC patients were selected from a total of 583 records. Afterwards, this number was distributed to three examiners for manual assessments. Each examiner was responsible for selecting dental records that contained an ORN description, resulting in 20 dental records.
Results: Mean patient age was 60.3 years with males being the most affected sex (80.0%). The most affected area was the posterior region of the mandible (60.0%) followed by the anterior region of the mandible (20.0%) and the posterior region of the maxilla (10.0%). The factors most associated with ORN were dental conditions (70.0%) followed by isolated systemic factors (10.0%) and tumor resection (5.0%). There was total exposed bone closure in 50.0% of cases. The predominant treatment was curettage associated with chlorhexidine 0.12% irrigation (36.0%).
Conclusion: Poor dental conditions were related to ORN occurrence. ORN management through less invasive therapies was effective for the closure of exposed bone areas and avoidance of infection.
Keywords: Osteoradionecrosis, Head and neck neoplasms, Mandible, Conservative treatment, Maxilla


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30 April 2019
Vol. 45
No. 2 pp. 49~120

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