Abstract:
To review the conservative and surgical management options of osteoradionecrosis, in particular, highlighting the recent the use of anti-radiation fibrosis drugs (pentoxifylline, tocopherol and clodronate). We performed a literature review. The management options were divided into two groups, conservative and surgical management. Over the years several treatment options have been proposed including; conservative management (antibiotics, analgesics, oral hygiene), ultrasound therapy, hyperbaric oxygen therapy, surgical resection with reconstruction and more recently the use of anti-radiation fibrosis drugs (pentoxifylline, tocopherol and clodronate). Early or low grade ORN can be managed conservatively using a combination of treatment options. In advanced or refractory cases of ORN (pathological fracture, orocutaneous fistula) surgical treatment, at present, remains the only treatment option available. A new understanding of the pathophysiology of ORN (radiation induced fibroatrophic process) has lead to the development of new therapeutic management regimes. In advanced or refractory cases of ORN surgical treatment, including microvascular reconstructive techniques for bone and soft tissue, remains the only option available.
Rice, Polyzois, Ekanayake, Omer, Stassen, , , , (2015). The management of osteoradionecrosis of the jaws–a review. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 2015 Apr;13(2):101-9. https://www.ncbi.nlm.nih.gov/pubmed/25084627