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

OBJECTIVE: Osteoradionecrosis (ORN) is a bone aseptic necrosis which devel - ops on post-irradiated bone tissue of patients who underwent radiotherapy for head-neck tu - mors. 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 as - sess 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-pharma - cological treatment, as an effective protocol for eliminating the exposed bone sequestration, as well as the teeth eventually damaged by the ra - diotherapy, assessing that the epithelium can regenerate only on healthy and vital tissues. RESULTS: The reported patient underwent re - section 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 ra - diotherapy, the dental surgeon should be able to give an early diagnosis of the dental and maxillofacial related pathologies; he should al - so detect all the possible infective sources and administer any possible treatment in a short time, before the beginning or the prosecution of radiotherapy.