Managing Mandibular Osteoradionecrosis

Area of Science:

• Oncology
• Oral and Maxillofacial Surgery
• Radiation Oncology

Background:

• Mandibular osteoradionecrosis (MORN) is a severe complication following head and neck radiation therapy.
• Traditional treatment paradigms for MORN require re-evaluation due to recent therapeutic advancements.

Purpose of the Study:

• To review current MORN staging and management techniques.
• To propose an updated staging system guiding appropriate MORN treatment.
• To highlight a paradigm shift in MORN management.

Main Methods:

• A comprehensive literature review was conducted using PubMed/MEDLINE.
• Publications focusing on MORN staging and management were synthesized.
• A narrative review approach was employed.

Main Results:

• A significant shift away from hyperbaric oxygen therapy in MORN management is evident.
• Pentoxifylline and tocopherol show efficacy in early-stage MORN.
• Novel surgical techniques are emerging for moderate and late-stage MORN.

Conclusions:

• An updated MORN staging stratification is proposed, reflecting current therapeutic evidence.
• Contemporary MORN treatment algorithms integrate traditional and novel medical and surgical approaches.
• Early intervention strategies are crucial for effective MORN management.