Risk Factors for Osteoradionecrosis of the Jaw in the Era of Modern Head and Neck Radiotherapy
Year: 2023
Type: article
Abstract: Radiotherapy is an essential component of curative treatment for head and neck cancer, either as a neoadjuvant or adjuvant treatment to surgery or as a definitive treatment with or without chemotherapy, depending on the stage of the disease and general health.However, aggressive RT or chemoradiotherapy can result in radiation-induced severe late toxicities, including the severely debilitating osteoradionecrosis of the jaws (ORNJ), which may affect a relatively small but significant proportion of this patient population.ORNJ is characterized by necrosis of bone tissue and failure to heal for at least three months.In the majority of cases, ORNJ progresses gradually, worsening and becoming more painful, which results in infection and pathological fracture.In the absence of a proven curative treatment other than aggressive surgeries, the prevalence of ORNJ could theoretically be decreased by implementing a wellorganized multidisciplinary oral care program and reducing the ORNJ-related risk factors.These risk factors include the patient, the tumor, pre-radiotherapy mandibular surgery, tooth extractions, implant placement, radiation modality, and radiation dosimetryrelated factors.Therefore, the present paper provides a literature review and update on the established and frequently disputed risk factors underlying ORNJ and their radiobiological bases.
Source: Acta Scientific Dental Scienecs
Authors: Erkan Topkan, Busra Yilmaz, Efsun Somay
Institutions: Başkent University, Bahçeşehir University
Language: English
Subfield: General Dentistry
Field: Dentistry
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4385417552