Changing trend in management of Osteoradionecrosis of the mandible: A case report

Abstract

Osteoradionecrosis (ORN) is a condition that results following radiotherapy for head and neck cancer in an appreciable number of patients. ORN is irreversible and extremely difficult to treat. Number of theories about the pathogenesis of Osteoradionecrosis (ORN) has been proposed in the past including the theory of radiation, trauma, infection and widely accepted theory of hypoxia, hypovascularity and hypocellularity and recently fibro-atrophic theory of ORN was proposed. Each theory has consequent implications on treatment. Fibro atrophic theory replaces the use of hyperbaric oxygen (HBO) with drugs like Pentoxifylline, a vasodilator that also inhibits fibrosis, and Tocopherol (vitamin E) to reduce damage caused by free radicals. In this case report we have achieved impressive results in terms of reversing the process of ORN using these agents suggesting that this theory and these agents could form the basis of effective treatment and prevention of ORN.