Osteorradionecrosis mandibular como consecuencia del tratamiento con radioterapia

Introduction: Radiotherapy is used for the treatment of head and neck cancer. Mandibular osteoradionecrosis is a typical complication of irradiated patients. This growing use of radiotherapy requires that dentists are aware of the prevention, diagnosis and treatment of its complications. Objective: Present a clinical case of mandibular osteoradionecrosis. Clinical case: A case is presented of a white male 68-year-old inveterate smoker and drinker patient with a diagnosis of epidermoid nasopharyngeal carcinoma (Stage II). After discharge from the dental services, the patient received radiotherapy on the primary site and ganglion regions of the neck, achieving complete response from the primary tumor and its ganglion metastases. At ten months from treatment he started with tooth mobility of the 48, periodontal abscesses at repetition, pain, impossibility to chew and trismus. Intraoral exploration found bone exposure in the right mandibular body. Mandibular radiography revealed osteolysis. A diagnosis was achieved of mandibular osteoradionecrosis. Analysis in head and neck multidisciplinary consultation advised radical surgical treatment: segmental mandibulectomy and reconstruction with a resistance plate. The patient had a favorable evolution and reports satisfaction with the functional improvement achieved. Conclusions: In this case mandibular osteoradionecrosis was associated to periodontitis of the 48 and toxic habits. The goal of treatment should be prevention, and the role of dentists is vital. Complex as it is, the procedure achieved eradication preserving the esthetic and functional characteristics. Key words: osteoradionecrosis, radiotherapy, prevention, control.