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Osteoradionecrosis of the jaws: A retrospective cohort study


1 Department of Dental and Prosthetic Services, Tata Memorial Hospital, TMC; Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
2 Department of Dental and Prosthetic Services, Tata Memorial Hospital, TMC; Homi Bhabha National Institute (HBNI); Fellowship in Dental and Prosthetic Oncology, Homi Bhabha National Institute, Mumbai, Maharashtra, India
3 Department of Dental and Prosthetic Services, Tata Memorial Hospital, TMC; Homi Bhabha National Institute (HBNI); Fellowship in Dental and Prosthetic Oncology, Homi Bhabha National Institute University, Mumbai, Maharashtra, India
4 Homi Bhabha National Institute (HBNI); Fellowship in Dental and Prosthetic Oncology, Homi Bhabha National Institute University; Department of Dental and Prosthetic Services, Tata Memorial Centre-Advanced Centre for Treatment, Research and Education in Cancer (TMCACTREC), TMC, Mumbai, Maharashtra, India
5 Dental Department, The Sultanís Special Force Medical Centre, Azaiba Garisson, Muscat, Sultanate of Oman
6 Homi Bhabha National Institute (HBNI); Professor, Department of Radiation Oncology, Tata Memorial Hospital, TMC, Mumbai, Maharashtra, India

Correspondence Address:
Madhura R Sharma,
Department of Dental and Prosthetic Surgery, HBB-217, Tata Memorial Hospital, Parel, Mumbai -†400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_248_20

Introduction: Radiotherapy (RT) combined with chemotherapy and surgery is the indicated treatment for head and neck cancers. Even with the advent of modern technological advances in RT and improved oral hygiene awareness, osteoradionecrosis (ORN) still remains as one of the most debilitating side effects of RT. Methodology: This is a retrospective review assessing 72 patients aged over 18 years of age reporting in the Dental Department, for treatment of ORN from April 2010 to July 2019. Each patient was clinically examined and treated according to standard protocol. The stage of ORN was noted at the diagnosis and at follow-up. The demographic data, the tumor characteristics, and the treatment of patients were evaluated using descriptive statistics. Results: At the time of diagnosis, 84.7% of the study population was found to have Epstein Type II chronic persistent nonprogressive lesions and 11.1% of the cohort had Type III active progressive lesions. Statistically significant correlation (P = 0.00) was found for ORN grade at diagnosis and at follow-up. ORN being a chronic pathology, stabilization of the disease was observed in 72.3% of cases. The resolution of the necrotic lesion and down staging of the disease was seen only in 2.8% of patients. Conclusion: ORN is mainly a chronic long standing pathology which is difficult to treat completely. Stabilization of symptoms and preventing further spread of the necrotic lesion should be the ultimate aim of the treatment to improve the quality of life of the patients.


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