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PMID: 20119841 Published · ppublish English Journal Article Review

Osteoradionecrosis of the jaws--a current overview--part 1: Physiopathology and risk and predisposing factors.

Oral and maxillofacial surgery ·Vol. 14 ·No. 1 ·2010-03-00 ·Pages 3-16

Chrcanovic BR, Reher P, Sousa AA, Harris M

Abstract

The aim of this paper is to explore the current theories about definition, classification, incidence and physiopathology of osteoradionecrosis (ORN) of the jaws. Moreover, it is discussed the predisposing and risk factors for the development of osteoradionecrosis based on the literature review. Osteoradionecrosis is one of the most serious oral complications of head and neck cancer treatment. Osteoradionecrosis is a severe delayed radiation-induced injury, characterised by bone tissue necrosis and failure to heal. Osteoradionecrosis either stabilises or gradually worsens and is notoriously difficult to manage. The most widely accepted theory to explain its cause until recently was the theory of hypoxia, hypovascularity and hypocellularity. A new theory for the pathogenesis of osteoradionecrosis was proposed. The clinical presentations of osteoradionecrosis are pain, drainage and fistulation of the mucosa or skin that is related to exposed bone in an area that has been irradiated. The tumour size and location, radiation dose, local trauma, dental extractions, infection, immune defects and malnutrition can predispose its development. A better understanding of risk factors for the development ORN and of the underlying pathophysiology may improve our ability to prevent this complication and help to improve the prognosis for those being treated for osteoradionecrosis.

MeSH Terms
Bacterial Infections/diagnosis,pathology,physiopathology Dose-Response Relationship, Radiation Endothelium, Vascular/pathology,physiopathology Humans Jaw/pathology,radiation effects Jaw Diseases/diagnosis,pathology,physiopathology Osteoblasts/pathology,physiology,radiation effects Osteoclasts/pathology,physiology,radiation effects Osteomyelitis/diagnosis,pathology,physiopathology Osteoradionecrosis/diagnosis,pathology,physiopathology Radiodermatitis/diagnosis,pathology,physiopathology Risk Factors Skin/pathology,radiation effects Thrombosis/diagnosis,pathology,physiopathology
Authors & Affiliations
4 authors, click to expand affiliations / ORCID
Chrcanovic Bruno Ramos
brunochrcanovic@hotmail.com
Reher Peter
Sousa Alexandre Andrade
Harris Malcolm
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Article Info
Journal
Oral and maxillofacial surgery
Abbr.
Oral Maxillofac Surg
ISSN
1865-1569
DOI
10.1007/s10006-009-0198-9
Email
brunochrcanovic@hotmail.com
Published
2010-03-00
Pages
3-16
Language
English
Region
Germany
NLM ID
101319632
Subset
IM
External Links
PubMed source DOI: 10.1007/s10006-009-0198-9 View journal details
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