Prevention and treatment of osteoradionecrosis of the jaws

• Main Authors: HE Yue, LI Xiaoguang
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Prevention and Treatment for Stomatological Diseases 2019-03-01
• Series: 口腔疾病防治
• Subjects: Osteoradionecrosis，; Osteoradionecrosis of the jaws，; Mandible，; Reconstruction，; Speech disorder，; Radiotherapy，; Chemotherapy，
• Online Access: http://www.kqjbfz.com/EN/10.12016/j.issn.2096-1456.2019.03.002

Radioactive jaw necrosis is a serious complication of head and neck radiotherapy. This complication 􀆳s main characteristics are chronic necrosis and infection, and its clinical manifestations are local pain, mouth opening re⁃ striction, speech disorder, dysphagia, exposure of dead bone, prolonged healing of facial and neck soft tissue fistula, and even pathological fracture, which brings great pain to the patient􀆳s body and mind. Radioactive jaw necrosis has become a clinical problem in the field of medicine, specifically for maxillofacial surgery of the external head and neck. The pathogenesis of radiation⁃induced jaw necrosis is still unclear, but high radiotherapy dose, extraction of teeth after radio⁃ therapy and surgical trauma are recognized as high⁃risk factors. The diagnosis of radiation⁃induced jaw necrosis needs to be combined with the patient􀆳s radiotherapy history, clinical symptoms and imaging examination. Conservative or sur⁃ gical treatment should be selected according to its clinical classification and stages, and the prevention of radiation⁃in⁃ duced jaw necrosis should be emphasized. The key points are to remove dental caries, residual roots and crowns before radiotherapy; improve radiotherapy technology; and take preventive measures against high⁃risk factors. In recent years, the diagnosis and treatment of radiation⁃induced jaw necrosis has gradually become standardized and individualized. This article reviews the progress of treatment and research on radiation⁃induced jaw necrosis at home and abroad in terms of its definition, etiology, risk factors, diagnosis, treatment and prevention to provide reference for clinical treat⁃ ment.