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Int J Oral Maxillofac Surg 2019 Apr 10. Epub 2019 Apr 10.

Oral and Maxillofacial Unit, Monash Health, Victoria, Australia.

Osteoradionecrosis (ORN) is an infrequent but serious complication of radiotherapy, especially in the head and neck region. It is a slowly progressive condition, with management in the early stages focused on symptom control, and surgery usually reserved for advanced ORN. However, established ORN is difficult to treat. Read More

Imaging Sci Dent 2019 Mar 25;49(1):53-58. Epub 2019 Mar 25.

Department of Oral and Maxillofacial Radiology, The Nippon Dental University, School of Life Dentistry at Niigata, Niigata, Japan.

Purpose: To present characteristic findings of Tc-99m hydroxymethylene diphosphonate (HMDP) scintigraphy, computed tomography (CT), and magnetic resonance (MR) imaging for osteonecrosis in the mandible, especially osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ).

Materials And Methods: Thirteen patients with MRONJ and 7 patients with ORN in the mandible underwent Tc-99m HMDP scintigraphy, CT, and MR imaging (T1-weighted images [T1WI], T2-weighted images [T2WI], short inversion time inversion recovery images [STIR]), diffusion-weighted images [DWI], and apparent diffusion coefficient [ADC] mapping). The associations of scintigraphy, CT, and MR imaging findings with MRONJ and ORN were analyzed using the chi-square test with the Pearson exact test. Read More

Int J Radiat Oncol Biol Phys 2019 Mar 7. Epub 2019 Mar 7.

Hyperbaric Medicine Unit, St. Richard's Hospital, Chichester, United Kingdom.

Purpose: Hyperbaric oxygen (HBO) has been advocated in the prevention and treatment of osteoradionecrosis (ORN) of the jaw after head and neck radiation therapy, but supporting evidence is weak. The aim of this randomized trial was to establish the benefit of HBO in the prevention of ORN after high-risk surgical procedures to the irradiated mandible.

Methods And Materials: HOPON was a randomized, controlled, phase 3 trial. Read More

J Korean Assoc Oral Maxillofac Surg 2019 Feb 26;45(1):21-28. Epub 2019 Feb 26.

Departament of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.

Objectives: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center. Read More

BMJ Open 2019 Mar 4;9(3):e026662. Epub 2019 Mar 4.

Oral and Maxillofacial Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

Introduction: Osteoradionecrosis (ORN) of the mandible is a painful and debilitating condition occurring after radiotherapy to the head and neck to treat cancer. For decades, hyperbaric oxygen (HBO) has formed the mainstay of the early management of ORN. Literature about the efficacy of HBO is contentious. Read More

Oral Dis 2019 Mar 1. Epub 2019 Mar 1.

Stomatology Department, School of Dentistry, São Paulo University, São Paulo, Brazil.

Background And Purpose: Osteoradionecrosis (ORN) is one of the most severe adverse effects of radiotherapy (RT) to the head and neck region. Medication-induced osteonecrosis of the jaw has been reported among patients using bisphosphonates. However, the impact of RT on osteonecrosis in patients using bisphosphonates has not yet been described. Read More

Clin Nucl Med 2019 May;44(5):e345-e346

Radiodiagnosis, Tata Memorial Hospital, Mumbai, India.

Differentiating osteoradionecrosis (ORN) from tumor recurrence is challenging. This report is rare documentation of false-positive F-FDG PET scan attributed to ORN in a patient previously treated for carcinoma of base of tongue (Ca BOT). Extraordinarily high F-FDG uptake was seen in right ramus (SUVmax, 17. Read More

Laryngoscope 2019 Feb 20. Epub 2019 Feb 20.

Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Taiwan.

Objective: There is no useful tool to clinically predict the occurrence of osteoradionecrosis (ORN) of the mandible quantitatively. The aim was to investigate the risk factors, including different modalities of radiotherapy, for developing mandibular ORN in patients undergoing marginal mandibulectomy and postoperative radiotherapy.

Methods: Between January 2006 and December 2012, 167 subjects who underwent marginal mandibulectomy and postoperative radiotherapy with different modalities were enrolled. Read More

J Clin Exp Dent 2019 Jan 1;11(1):e91-e96. Epub 2019 Jan 1.

MD, DDS, MS, PhD, EBOS, OMFS. Chairman and Professor of Oral and Maxillofacial Surgery, Faculty of Medicine and Health Sciences, University of Barcelona. Director of the Master's Degree Program in Oral Surgery and Implantology (EFHRE International University/FUCSO). Coordinator/Researcher of the IDIBELL Institute. Head of the Oral Surgery, Implantology and Maxillofacial Surgery Department of the Teknon Medical Center, Barcelona (Spain).

Background: The decision-making process about how to rehabilitate edentulous osseous defects in patients with head and neck cancer history can be complex. Even though, endosseous dental implants could be considered to be the first choice for treating these patients, it is highly important to be aware of the complications that might occur. The aim of this report was to describe the clinical features of mandibular fracture after dental implants placement on a cancer irradiated patient and update the available information about this event. Read More

J Craniomaxillofac Surg 2019 Mar 28;47(3):516-522. Epub 2018 Nov 28.

Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China. Electronic address:

Objective: To explore the application of modified resection compared with traditional segmental resection of the mandible for patients with anterior floor of the mouth and tongue squamous cell carcinoma (SCC) without infiltration of the mandible.

Subjects And Methods: This is a retrospective study including 36 eligible patients with anterior floor of the mouth SCC(9 patients received modified mandibulectomy, and 27 patients received segmental mandibulectomy).

Results: No patients in the modified mandibulectomy group developed recurrence in the floor of the mouth, and all of the patients survived. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 12;32(12):1567-1571

Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou Guangdong, 515031, P.R.China.

Objective: To evaluate the reliability and effectiveness of a deep circumflex iliac artery based iliac-internal oblique musculofascial chimeric flap (DCIA-IIOF) in reconstruction of complex oromandibular defect.

Methods: Between January 2010 and December 2015, DCIA-IIOFs were used to repair complex oromandibular defects in 11 patients. There were 8 males and 3 females, with an age of 27-75 years (median, 56 years). Read More

Am J Otolaryngol 2019 Mar - Apr;40(2):314-318. Epub 2018 Dec 7.

THANC (Thyroid, Head and Neck Cancer) Foundation, 10 Union Square East, Suite 5B, New York, NY 10003, USA; Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel Medical Center, 10 Union Square East, Suite 5B, New York, NY 10003, USA.

Background: Osteoradionecrosis (ORN) is a well-known complication following irradiation of head and neck malignancies. ORN commonly occurs in the mandible but is rarely reported in the hyoid bone.

Case Presentation: A 76-year-old female with a history of oropharyngeal squamous cell carcinoma presented with pharyngocutaneous fistula 14 years after primary chemoradiation. Read More

Oral Oncol 2018 Dec 2;87:126-130. Epub 2018 Nov 2.

Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, De Boelelaan 1117, Amsterdam, the Netherlands. Electronic address:

Objectives: Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.

Materials And Methods: Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Read More

Int J Oral Maxillofac Implants 2019 January/February;34(1):e7–e11. Epub 2018 Dec 5.

The purpose of this case report was to assess whether patient-specific implants (PSI: Xillocs) and soft tissue flaps contribute in reconstructing large mandibular defects. Five patients with a medical situation and history not suitable for free microvascular bone flaps were operated with PSI and evaluated. The mean follow-up time was 12 months. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2019 Apr 14;136(2):83-86. Epub 2018 Nov 14.

Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.

Objectives: Osteoradionecrosis (ORN) of the mandible is a common complication of head and neck radiotherapy and often requires surgical treatment. Squamous cell carcinoma (SCC) can be exceptionally discovered within zones of ORN on histological examination of the operative specimen. The authors discuss the management of these lesions based on a short patient series. Read More

Med Oral Patol Oral Cir Bucal 2018 Nov 1;23(6):e633-e638. Epub 2018 Nov 1.

School of Dentistry, Federal University of Minas Gerais, Department of Clinical, Pathology and Surgery, Presidente Antônio Carlos, 6627 - 31270-901- Pampulha Belo Horizonte - MG, Brazil,

Background: Osteoradionecrosis (ORN) is one of the most serious complications of head and neck radiotherapy and is considered a public health problem worldwide. This study aims to determine the prevalence and associated factors of ORN in patients undergoing radiotherapy for head and neck malignancy.

Material And Methods: A cross-sectional retrospective study was conducted, in which all medical records of patients undergoing head and neck radiation in the period between 2006 to 2015 (10 years) were examined. Read More

J Craniomaxillofac Surg 2018 Nov 24;46(11):1960-1967. Epub 2018 Aug 24.

Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Zhi-zao-ju Rd, No. 639, Shanghai, 200011, China. Electronic address:

Purpose: Osteoradionecrosis of the mandible (ORNM) is one of the most devastating complications following radiotherapy. Postoperative relapse (POR) occurs with high incidence even if a radical resection is performed. The current investigation was designed to identify prognostic factors for POR and to establish a nomogram model to estimate the risk for the onset of POR of ORNM. Read More

J Prosthodont Res 2018 Oct 3;62(4):518-521. Epub 2018 Aug 3.

Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.

Patients: Seventy-one and 73 years-old males visited a perioperative oral care support center to receive perioperative oral management during tongue cancer (TNM) treatment. To improve their quality of life (QOL) during brachytherapy while preventing radiation-related complications including osteoradionecrosis due to Au grain brachytherapy, spacers for their maxilla and mandible were designed with consideration of wearing condition at an isolation ward. The spacer was created with unilateral design and with consideration of the tongue mobility during day and night. Read More

J Craniomaxillofac Surg 2018 Sep 30;46(9):1631-1636. Epub 2018 Jun 30.

Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. Electronic address:

Diffuse sclerosing osteomyelitis (DSO) of the mandible is a poorly understood chronic disease. It is assumed to be a form of chronic osteomyelitis. Other forms of chronic osteomyelitis are chronic suppurative osteomyelitis (CSO) and osteoradionecrosis (ORN). Read More

Natl J Maxillofac Surg 2018 Jan-Jun;9(1):78-81

Department of Oral and Maxillofacial Surgery, Ministry of Health, Riyadh 13226, India.

A number of dressings containing silver have been recently introduced into the wound care market as increased resistance to antibiotics has become a problem in treating infected wounds. A 54-year-old male, with adenoid cystic carcinoma treated by segmental resection and reconstruction of mandible using reconstruction plate with concomitant radiotherapy, resulted in a deep extraoral nonhealing necrotic, exuding, malodorous, and painful wound. Erythema, eczema, and trophic changes were surrounding the skin. Read More

JAMA Facial Plast Surg 2018 Sep;20(5):401-408

Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota.

Importance: The clinical and financial implications of the timing of dental rehabilitation after a fibula free tissue transfer (FFTT) for osteoradionecrosis (ORN) and osteonecrosis (ON) of the mandible have yet to be established.

Objective: To compare the outcomes of primary implantation vs secondary implantation after FFTT for ORN and ON of the mandible.

Design, Setting, And Participants: A retrospective review was conducted of 23 patients at a single tertiary academic referral center undergoing primary implantation or secondary implantation after FFTT for ORN and ON from January 1, 2006, to November 10, 2015. Read More

Curr Opin Otolaryngol Head Neck Surg 2018 Aug;26(4):254-259

Ochsner Health System New Orleans, Department of Otolaryngology, New Orleans, LA, USA.

Purpose Of Review: Despite recent advances in radiotherapy, osteoradionecrosis (ORN) remains a common and difficult complication of radiation therapy in head and neck cancer patients. Available treatment options are complementary to its complex pathophysiology and the currently available theories of ORN development. The efficacy of hyperbaric oxygen therapy has recently been questioned, and therapies targeting the fibroatrophic process have become a focus of ORN treatment. Read More

Oral Surg Oral Med Oral Pathol Oral Radiol 2018 08 7;126(2):102-106. Epub 2018 Mar 7.

Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China. Electronic address:

Objectives: Osteoradionecrosis of the mandible is a late radiation-induced complication, which is a major concern in survivors of head and neck cancer.

Study Design: In this study, we present a case of a patient with nasopharyngeal carcinoma who developed extensive bilateral osteoradionecrosis of the ascending ramus of the mandible. After preoperative virtual surgical planning, the obtained data were used to fabricate patient-specific cutting templates. Read More

J Oral Maxillofac Surg 2018 Aug 20;76(8):1816-1822. Epub 2018 Feb 20.

Professor, Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:

Mandible plays a pivotal role for both function (mastication, swallowing, and phonation) and aesthetic. Traumas, osteomyelitis, osteoradionecrosis, and benign or malignant neoplasm can cause mandibular defect. Several techniques have been proposed for mandibular reconstruction along the past decades. Read More

Head Neck 2018 07 9;40(7):1453-1460. Epub 2018 Mar 9.

Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California.

Background: Anti-Sclerostin antibody (Scl-Ab) is a promising new bone anabolic therapy. Although anti-Scl-Ab stimulates bone formation and repair in the appendicular and axial skeleton, its efficacy in the craniofacial skeleton is still poorly understood.

Methods: Using an established model of Down syndrome-dependent bone deficiency, 10 Ts65Dn mice and 10 wild-type mice were treated weekly via i. Read More

Mol Clin Oncol 2018 Jan 2;8(1):61-67. Epub 2017 Nov 2.

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.

It was hypothesized that fluorodeoxyglucose (FDG) uptake on post-treatment follow-up positron emission tomography with computed tomography (PET CT; using PET CT to monitor and rule out recurrence and metastasis of head and neck carcinoma) would be useful for detecting and understanding the disease state of osteoradionecrosis (ORN) of the jaw. The present study included 14 patients who developed mandibular ORN following radiation therapy (RT) for head and neck cancer and underwent follow-up PET CT several times following RT. Areas exhibiting FDG uptake were retrospectively assessed on post-treatment follow-up PET CT images and were classified into three types: Spot type: Only spot accumulation of FDG; localized type: Accumulation of FDG restricted to within the bone resorption area; extensive type: Accumulation of FDG extending into surrounding soft tissue. Read More

Am J Clin Oncol 2018 Dec;41(12):1276-1280

International Head and Neck Scientific Group, Udine, Italy.

The objective of this review is to discuss factors related to the risk of osteoradionecrosis (ORN) and how to minimize the likelihood of this complication. A PubMed search for publications pertaining to ORN within the last 3 years was conducted revealing 44 publications. The bibliographies of these publications were reviewed to identify additional references spanning a longer time period. Read More

Trials 2018 Jan 10;19(1):22. Epub 2018 Jan 10.

CRUK Liverpool Cancer Trials Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.

Background: Osteoradionecrosis of the mandible is the most common serious complication of radiotherapy for head and neck malignancy. For decades, hyperbaric oxygen has been employed in efforts to prevent those cases of osteoradionecrosis that are precipitated by dental extractions or implant placement. The evidence for using hyperbaric oxygen remains poor and current clinical practice varies greatly. Read More

J Craniofac Surg 2018 May;29(3):e248-e250

Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain.

Background: Reconstruction of an oromandibular defect presents a considerable surgical challenge. But since the advent of microvascularized free flap reconstructive surgery, outcomes have improved significantly so that today almost any defect may be reconstructed. Recently, virtual surgical planning has reduced surgical time, the morbidity associated with surgery, and surgical precision. Read More

Head Neck 2018 03 22;40(3):E21-E24. Epub 2017 Dec 22.

Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background: Heterotopic ossification along free flap pedicles has been reported. Reports suggest that subperiosteal dissection of the pedicle from the bone during the harvest of the fibula free flap may predispose the pedicle to heterotopic ossification.

Methods: A 56-year-old man with history of a T2N1M0 squamous cell cancer of the left tonsil who was treated with chemoradiation developed osteoradionecrosis of the mandible requiring fibula free flap reconstruction. Read More

World J Clin Cases 2017 Oct;5(10):384-389

Government Royapettah Hospital, Chennai 600014, India.

Surgical resection of mandible owing to benign, malignant neoplasm, osteoradionecrosis is common. The resection can be total or segmental depending on the lesion. Loss of mandibular continuity causes deviation of remaining mandibular segment towards the resected side and rotation inferiorly due to muscle pull and scar contracture affecting mastication and esthetics. Read More

J Craniomaxillofac Surg 2017 Nov 1;45(11):1778-1783. Epub 2017 Sep 1.

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine (Chief: Prof. Komori Takahide), Kobe, Japan.

Objective: Few studies evaluate condylar movement following mandibular reconstruction. The main objective of this study was to show that axial four-dimensional computed tomography (4DCT) could visualize bilateral protrusive condylar movement directly. We used axial 4DCT images to assess condylar protrusion in patients who underwent mandibular reconstruction. Read More

Biomed Res Int 2017 30;2017:3125842. Epub 2017 Aug 30.

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Background: This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis.

Methods: Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals.

Results: Ten of eleven (91%) cortices near the inferior border of the mandible at the anterior margins were necrotic. Read More

J Reconstr Microsurg 2018 Feb 13;34(2):108-120. Epub 2017 Sep 13.

Department of Plastic Surgery, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background:  Free fibula flap (FFF) is considered gold standard in the reconstruction of mandibular defects. Despite the frequent use, patients' quality of life (QoL) after reconstruction has been sparsely investigated. This study aims to evaluate QoL and outcomes in patients who have undergone FFF reconstruction of segmental mandibular defects. Read More

Int J Oral Maxillofac Surg 2018 Feb 4;47(2):214-219. Epub 2017 Sep 4.

Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Osteoradionecrosis is defined as bone death secondary to radiotherapy. There is a relationship between the radiation dose received and the occurrence of osteoradionecrosis of the jaws, with the risk increasing above a dose of 60Gy. In cases of class III mandibular osteoradionecrosis, a segmental resection can be indicated. Read More

Oral Oncol 2017 09 16;72:98-103. Epub 2017 Jul 16.

Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address:

Objectives: To evaluate the incidence of, and risk factors associated with, mandibular osteoradionecrosis (MORN) following radiation therapy (RT) for oral cavity and oropharyngeal cancers.

Materials And Methods: Patient and treatment records of 252 consecutive patients with oral cavity or oropharynx cancers treated with RT by a single radiation oncologist at a high volume academic institution from August 2009 to December 2015 were retrospectively reviewed. A Cox regression model was used to assess factors associated with the development of MORN. Read More

J Oral Maxillofac Surg 2017 Nov 15;75(11):2334-2339. Epub 2017 Jul 15.

Staff Member, Department of Oral and Maxillofacial Surgery, TREANT Scheper Hospital, Emmen, The Netherlands.

Purpose: In maxillofacial surgery, hyperbaric oxygen treatment is used almost exclusively as adjunctive therapy for osteoradionecrosis of the mandible in irradiated patients. It also is used to prevent the occurrence of osteoradionecrosis in the irradiated patient when dental surgery is indicated. Theoretically, hyperbaric oxygen therapy should benefit the nonirradiated patient in maxillofacial surgery (eg, patients with persistent intraoral wound dehiscences after bone grafting). Read More

Cancer Treat Rev 2017 Sep 18;59:79-92. Epub 2017 Jul 18.

Coordinator of the International Head and Neck Scientific Group, Italy.

Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. Read More

Plast Reconstr Surg 2017 Aug;140(2):381-389

Houston, Texas From the Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center.

Background: A significant percentage of patients who undergo segmental mandibulectomy for head and neck cancer will develop a new or recurrent cancer or osteoradionecrosis, necessitating a second mandibulectomy and reconstruction. In this scenario, many surgeons are reluctant to perform a reconstruction with an osseous flap because of the presumed increased morbidity and complexity. The purpose of this study was to evaluate the safety and efficacy of performing a second free fibula flap reconstruction after repeated segmental mandibulectomy. Read More

Radiother Oncol 2017 08 18;124(2):232-239. Epub 2017 Jul 18.

Purpose: To determine dosimetric parameters associated with osteoradionecrosis (ORN) in oropharyngeal cancer (OPC) patients in the IMRT era.

Material And Methods: Subsequent to institutional review board approval, we identified ORN in OPC patients treated with IMRT from 2002 to 2013. 1:2 case-control matching was implemented. Read More

J Craniofac Surg 2017 Sep;28(6):e577-e579

Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University, Wuhan, China.

Osteoradionecrosis occurs in 4.74% to 37.5% of patients following radiation therapy for head and neck cancer. Read More

J Craniofac Surg 2017 Jul;28(5):1236-1241

Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Palo Alto, CA.

Background: Craniofacial distraction osteogenesis (DO) is a common treatment modality today. Despite its numerous advantages, however, concerns have been expressed regarding the use of DO in the irradiated setting.

Methods: A systematic review was performed to identify all published reports of patients who underwent DO of the irradiated craniofacial skeleton. Read More

Sci Rep 2017 06 14;7(1):3479. Epub 2017 Jun 14.

Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.

Osteoradionecrosis of the mandible (ORNM) is one of the most dreaded complications of radiotherapy. The poor healing capacity of soft tissue after radiation may lead to surgical failure. The current study was designed to identify prognostic factors for postoperative infection (PPI) and propose corresponding prophylaxis and intervention protocols. Read More

Cancer 2017 Oct 13;123(19):3691-3700. Epub 2017 Jun 13.

Department of Radiation Oncology, the Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.

Background: Osteoradionecrosis (ORN) of the mandible is a late toxicity affecting patients treated with radiotherapy for head and neck malignancies. To the authors' knowledge, ORN has no standardized grading system and its reporting is based on retrospective findings in heterogeneous patient populations. The rate of ORN in the era of intensity-modulated radiotherapy (IMRT) still is unknown. Read More

Radiother Oncol 2017 06 23;123(3):401-405. Epub 2017 May 23.

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address:

Purpose: We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT).

Methods And Materials: We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test. Read More

J Craniofac Surg 2017 May;28(3):826-830

Ghazi Al-Hariri Specialized Surgeries Hospital, Medical City, Baghdad, Iraq.

The most common causes of mandibular defects are ablative surgery of benign or malignant tumors, severe trauma, inflammatory diseases, and osteoradionecrosis. War injuries are another cause for mandibular defect. Reconstruction of the mandible is considered a challenge to the maxillofacial surgeon due to the accompanying functional and cosmetic importance. Read More

J Surg Oncol 2017 Aug 18;116(2):258-262. Epub 2017 Apr 18.

Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas.

Background: A double island free fibula (DIFF) flap can be used for reconstruction of through-and-through or complex mandibulectomy defects, but prospective studies are lacking.

Methods: Prospective analysis of all double skin paddle fibula flaps performed from 2010 to 2016.

Results: Overall, 16 patients underwent reconstruction with a DIFF flap (average age: 59. Read More

J Oral Maxillofac Surg 2017 Jul 24;75(7):1567.e1-1567.e6. Epub 2017 Mar 24.

Department Head, Department of Plastic and Reconstructive Surgery, Azienda Ospedaliero Universitaria Ospedali Riuniti Trieste, Trieste, Italy. Electronic address:

Purpose: Computer-aided design-computer-aided modeling (CAD-CAM) has become standard in mandibular reconstruction because it offers better outcomes. Occasionally, the reconstructive plans need to be changed intraoperatively and the custom-made prefabricated devices may become inadequate. We present an efficient adjunct to the standard CAD-CAM technique that resolves this problem. Read More