Osteoradionecrosis of the jaw caused by periapical periodontitis: A case report

Sugimoto, Keisuke; Tsuchiya, Shunji; Hara, Kenji; Matsushita, Yoshihiro; Fujio, Masahito; Hibi, Hideharu

doi:10.1016/j.ajoms.2017.02.002

Cited by 2 publications

(1 citation statement)

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“…This study focused on the role of infection in exacerbation of ORN. Infection control is an important factor in the treatment of ORN 19 – 21 . We hypothesized that accumulation of infection is an exacerbating factor of ORN and may be a trigger for pathological fracture.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for pathological fracture in patients with mandibular osteoradionecrosis

Ohori

Iwata

Takeda

et al. 2023

Sci Rep

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Osteoradionecrosis (ORN) often results in pathological fractures through progression. We aimed to identify the risk factors for pathological fracture in patients with mandibular ORN. Seventy-four patients with mandibular ORN were included in this retrospective study. We investigated various risk factors for pathological fracture in patients with mandibular ORN, including number of mandibular teeth with a poor prognosis each at initial evaluation before radiation therapy (RT) and when fracture occurred, and the proportion of antibiotic administration period in a follow-up duration after RT. The rate of occurrence of pathological fractures in patients with mandibular ORN was 25.7%. The median of duration between RT completion and fracture occurrence was 74.0 months. We found that pathological fracture was significantly associated with a larger number of mandibular teeth with a poor prognosis at initial evaluation before RT (P = 0.024) and when fracture occurred (P = 0.009). Especially, a larger number of mandibular teeth with P4 periodontitis, in other words severe periodontal status, was related to pathological fracture in both timings. The proportion of antibiotic administration period in a follow-up duration was also significant risk factor (P = 0.002). Multivariate analyses showed statistically significant associations between pathological fracture and a larger number of mandibular teeth with a poor prognosis when fracture occurred (hazard ratio 3.669). The patient with a larger number of mandibular teeth with P4 periodontitis may have a risk of not only occurrence of ORN but resulting in pathological fracture by accumulation of infection. Surgeons should consider extraction of those teeth regardless of before/after RT if necessary for infection control.

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Section: Discussionmentioning

confidence: 99%

Risk factors for pathological fracture in patients with mandibular osteoradionecrosis

Ohori

Iwata

Takeda

et al. 2023

Sci Rep

View full text Add to dashboard Cite

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Osteoradionecrosis of the Jaws: A Report of Nineteen Consecutive Cases

Tymofieiev

2018

J. Diagn. Treat. Oral Maxillofac. Pathol.

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Purpose: To study the clinical-radiological symptoms in post-radiological osteonecrosis of the jaws. Methods: The survey is based on the clinical study of 19 patients with osteoradionecrosis of the jaws that appeared after the radiation impact on the soft tissues what surrounds jaws, which was performed after the removal of malignant tumors of the soft tissues of the maxillofacial area. Results: Based on the examination of patients, clinical and radiological symptoms were studied in cases of osteoradionecrosis of the jaws, described methods of treatment and prevention of this disease. Conclusions: In osteoradionecrosis of the jaws there is a significant destruction of bone tissue, which is accompanied by the rejection of sequesters. After Х-ray influence on the soft tissues that surrounds jaws, changes in tissues and organs of the oral cavity are observed.

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Osteoradionecrosis of the jaw caused by periapical periodontitis: A case report

Cited by 2 publications

References 20 publications

Risk factors for pathological fracture in patients with mandibular osteoradionecrosis

Risk factors for pathological fracture in patients with mandibular osteoradionecrosis

Osteoradionecrosis of the Jaws: A Report of Nineteen Consecutive Cases

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