Lyons A, Ghazali N, et al.
The British journal of oral & maxillofacial surgery. Date of publication 2008 Dec 1;volume 46(8):653-60.
1. Br J Oral Maxillofac Surg. 2008 Dec;46(8):653-60. doi:
10.1016/j.bjoms.2008.04.006. Epub 2008 Jun 17.
Osteoradionecrosis of the jaws: current understanding of its pathophysiology and
treatment.
Lyons A(1), Ghazali N.
Author information:
(1)Department of Oral & Maxillofacial Surgery, 23rd Floor Guy's Tower, London SE1
9RT, United Kingdom.
During the past 80 years a number of theories about the pathogenesis of
osteoradionecrosis (ORN) have been proposed, with consequent implications for its
treatment. Until recently tissue hypoxia and its consequences were accepted as
the primary cause, and this led to the use of hyperbaric oxygen (HBO) for both
treatment and prevention of complications of radiotherapy in the head and neck.
The benefit of HBO has not been validated. A new theory for the pathogenesis of
ORN has proposed that damage to bone is caused by radiation-induced fibrosis.
Cells in bone are damaged as a result of acute inflammation, free radicals, and
the chronic activation of fibroblasts by a series of growth factors. New
treatments have therefore been devised that include pentoxifylline, a vasodilator
that also inhibits fibrosis, and tocopherol (vitamin E) to reduce damage caused
by free radicals. Impressive results in terms of reversing the process of ONR
have been reported using these agents. It has been suggested that this theory and
these agents could be the basis of future treatment and prevention of ORN.
DOI: 10.1016/j.bjoms.2008.04.006
PMID: 18562055 [Indexed for MEDLINE]
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