OSTEORADIONECROSIS in dental practiceppt

bone deformity due to radiation

1. OSTEORADIONECROSIS

2. Osteoradionecrosis (ORN) is the death of irradiated bone in the head and neck area, most commonly the jaw, that occurs after radiotherapy for cancer, failing to heal for at least three to six months. It results from radiation-induced damage to blood vessels, creating a bone with poor healing capacity and increased risk of breakdown and infection.

3. Symptoms include exposed bone, pain, swelling, and a range of complications that can affect jaw function, with prevention being key. What causes it?Radiotherapy:High-dose radiation damages the delicate blood vessels in the bone, leading to a hypocellular, hypovascular , and hypoxic (low in blood, oxygen, and cells) environment that impairs bone repair.

4. Mechanical insult:Trauma to the irradiated area, especially dental extractions, can trigger the breakdown of the weakened bone. Risk factorsRadiation dose and type: Higher radiation doses are linked to a greater risk of ORN.

5. Dental procedures: Tooth extraction after radiotherapy is a significant risk factor. Poor dental health: Pre-existing gum disease or caries (decay) can increase the risk. Symptoms Pain in the jawExposed , necrotic bone tissueSwelling and inflammationDifficulty opening the mouth (trismus)Fracture of the jawboneLoose teeth or jaw spiculesManagement and treatmentPrevention:Dental evaluations and treatments, including prophylactic extractions of problematic teeth, are crucial before radiotherapy

6. . Non-surgical interventions:Antiseptic mouthwashes and pain relief. Antibiotics to manage infection. Hyperbaric Oxygen Therapy (HBO): A controversial treatment that involves breathing pure oxygen in a pressurized chamber to improve blood flow and healing, though its efficacy is debated.

7. Surgical treatments:For severe cases, surgical removal of the affected bone and reconstruction with techniques like free tissue transfer may be necessary. Key takeaways ORN is a severe, long-term complication of head and neck radiotherapy that can significantly impact quality of life. Preventive dental care is vital to reduce the risk. Early diagnosis and a combined approach with nonsurgical and surgical treatments are key for managing this challenging condition

8. . Preventive dental care is vital to reduce the risk. Early diagnosis and a combined approach with nonsurgical and surgical treatments are key for managing this challenging condition