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Osteoradionecrosis related to mastication and parafunction
1Department of Otolaryngology, Wayne State University, Harper Hospital.
Oral Surgery, Oral Medicine, and Oral Pathology
|November 1, 1989
Summary
Mastication and parafunctional habits may cause osteoradionecrosis (ORN) years after radiation therapy, particularly in the mandible at doses over 6500 rad. Patients need dietary and habit guidance to prevent ORN.
Area of Science:
- Oral and Maxillofacial Surgery
- Radiation Oncology
- Dental Medicine
Background:
- Osteoradionecrosis (ORN) is a serious complication following radiation therapy for head and neck cancers.
- The exact etiologic factors contributing to the development of ORN are not fully understood.
- Mastication and parafunctional habits are increasingly recognized as potential contributors.
Observation:
- This study reviews three case reports of osteoradionecrosis.
- Bone necrosis was observed to occur even after extended periods post-radiation therapy.
- The mandible was the most frequently affected site, often at radiation dosage levels exceeding 6500 rad.
Findings:
- Mastication and parafunctional habits are identified as potential etiologic factors in osteoradionecrosis development.
- Delayed onset of bone necrosis, occurring long after radiation treatment, is a significant observation.
- High radiation doses (over 6500 rad) are strongly correlated with the occurrence of ORN, particularly in the mandible.
Implications:
- Patients receiving high-dose radiation (≥6500 rad) require specific post-treatment recommendations.
- Dietary consistency and the use of existing prostheses should be carefully managed to mitigate ORN risk.
- Educating patients on the harmful effects of parafunctional habits is crucial for preventing osteoradionecrosis.