Management of osteonecrosis of the jaws induced by radiotherapy in oncological patients: preliminary results

Abstract OBJECTIVE: Osteoradionecrosis (ORN) is a bone aseptic necrosis which develops on post-irradiated bone tissue of patients who underwent radiotherapy for head-neck tumors. The mandible presents a higher risk to develop ORN, if compared to the maxillary bone, due to its lower vascularization. The aim of the present study is to clinically assess the regenerative ability by the epithelial and connective tissues, in response to ORN onset. PATIENTS AND METHODS: Authors have verified the importance of the surgical-pharmacological treatment, as an effective protocol for eliminating the exposed bone sequestration, as well as the teeth eventually damaged by the radiotherapy, assessing that the epithelium can regenerate only on healthy and vital tissues. RESULTS: The reported patient underwent resection of a portion of the left mandible with an incomplete healing after the surgery. A second curettage was scheduled in order to remove the bands of necrotic tissue and to obtain a clinical remission of symptoms. CONCLUSIONS: In patients undergoing radiotherapy, the dental surgeon should be able to give an early diagnosis of the dental and maxillofacial related pathologies; he should also detect all the possible infective sources and administer any possible treatment in a short time, before the beginning or the prosecution of radiotherapy.