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Updated: Jun 2, 2026
Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology
Published on: August 22, 2022
Factors predictive of severity of osteoradionecrosis of the mandible
Shamit Chopra1, Dev Kamdar, Ozlem E Tulunay Ugur
1Department of Otolaryngology-Head and Neck Surgery, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, USA. shamitchopra@hotmail.com
Background:
An analysis of risk factors predictive of severe mandibular osteoradionecrosis (ORN) is needed to aid prophylaxis and management of this condition.
Methods:
We retrospectively analyzed 46 patients diagnosed between June 2002 and March 2009: 93% had mandibular ORN, which was staged 0 to III (Store and Boysen). Patient, tumor, treatment-related, and other variables were analyzed for association with mandibular ORN severity.
Results:
Oral or oropharyngeal tumors comprised 85% of our primary tumors, 80% were stage IV, and 91% were squamous cell carcinomas. Most patients (87%) received 3-dimensional (3D) conformal radiation therapy (RT), with 60 Gray (Gy) median dose; 28% and 72% received primary and adjuvant RT, respectively; 78% received chemotherapy, mostly concurrent (97%) and platinum-based (96%). Median time to development of ORN was 7.5 months. White ethnicity and secondary infection correlated significantly with stage III mandibular ORN (p = .038, p = .0007, respectively). Advanced age, stage IV, RT dose, post-RT, and lack of pre-RT dental extractions appeared predictive of severe mandibular ORN.
Conclusions:
The above-cited factors are predictive of severity and can potentially guide prophylaxis and management.
