Zygomatic bone forms major buttress of the facial skeleton and plays an important role in facial contour. Fractures of zygomatic complex are second most common only next to nasal bone fractures. Motor vehicle accidents and interpersonal violence are common causes. Bilateral fractures of zygomatic complex and zygomatic arch are very rare. We present a case report of isolated fractures involving bilateral zygomatic complex and zygomatic arch with oral submucous fibrosis, which is unique and first of its kind to be reported.

Exposure of bone to ionizing radiation results in devitalization of facial skeleton and necrosis of overlying soft tissues. The incidence of osteoradionecrosis ranges from 2% to 22% 1. It usually presents with symptoms ranging from pain, difculty in chewing, trismus, non-healing ulcers, stulas to extensive osteolysis resulting in a deterioration of quality of life1. Anatomically, head and neck is particularly more susceptible to Osteoradionecrosis. The mandible appears to be most commonly affected structure owing to factors such as relatively poor vascularity within this region, thin soft tissue coverage, mechanical stress and remodelling within this region due to masticatory forces3. Pentoxifylline has traditionally been used in the treatment of peripheral vascular and cerebrovascular diseases owing to its vasodilatory properties as well as anti-tumour necrosis effects.2In vivo studies have shown pentoxifylline to inhibit inammatory reactions, increase erythrocyte exibility thereby decreases viscosity of blood resulting in reduced potential for clotting1. Pentoxifylline has also shown to inhibit neutrophil adhesion and the production of some cytokines, such as TNF-α and IL-1 Vitamin E ( Tochopherol) has proven antioxidant effects that is effective in preventing lipid peroxidation which Is driven by free radical formation.4 This has potential effects in reducing the risk of coronary artery disease ,atherosclerosis and some cancers. This systematic review has been designed to address the medical management options and its outcomes with respect to the adverse effects in treating mild and moderate stages of osteoradionecrosis