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J Craniomaxillofac Surg 2020 Jun 9. Epub 2020 Jun 9.

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Chemistry, the Netherlands; Leiden University Medical Center, Department of Internal Medicine, Division of Endocrinology and Center for Bone Quality, Leiden, the Netherlands. Electronic address:

Objectives: The aim of this study was to assess the microarchitecture and turnover in irradiated cancellous mandibular bone and the relation with radiation dose, to elucidate the effects of radiotherapy on the mandible.

Patients And Methods: Mandibular cancellous bone biopsies were taken from irradiated patients and controls. Micro-CT scanning was performed to analyze microstructural bone parameters. Read More

Otolaryngol Head Neck Surg 2020 Jun 16:194599820931069. Epub 2020 Jun 16.

Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.

Objective: To describe the natural history of bone segment union in head and neck free flap procedures and detail the association of poor segment union with postoperative complications.

Study Design: Case series with chart review.

Setting: Single tertiary care referral center. Read More

J Stomatol Oral Maxillofac Surg 2020 Jun 11. Epub 2020 Jun 11.

Department of oral and maxillo-facial surgery, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium; Institut Roi-Albert-II, Cancérologie et Hématologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium. Electronic address:

Introduction: Osteoradionecrosis (ORN) remains a frequent complication of radiotherapy in head and neck cancer. As ORN management is often complex, it is essential to focus on its prevention, mainly by dental prophylaxis. The objectives of this study were to evaluate a dental preventive approach based on ORN data and to highlight individual risk factors statistically associated with time-to-ORN. Read More

Oral Dis 2020 Jun 12. Epub 2020 Jun 12.

Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy.

Objectives: The aim of this Systematic Review is to estimate the osteoradionecrosis rate in patients with head and neck cancer due to teeth extraction performed before radiotherapy and to identify possible risk factors.

Material And Methods: PRISMA protocol was used to evaluate and present the results. PubMed, Scopus, and Web of Science were used as search engines: English full-length papers of clinical studies, in peer-reviewed journals, were investigated. Read More

J Craniomaxillofac Surg 2020 Jul 22;48(7):621-631. Epub 2020 Feb 22.

Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea. Electronic address:

Purpose: Osteoradionecrosis (ORN) is known to be a refractory disease in the oral and maxillofacial field. The purpose of this study was to examine the effects of pentoxifylline (PTX) and tocopherol (TP) on an ORN animal model focused on bone healing.

Materials And Methods: A total of 48 Sprague-Dawley rats were used: 40 received a single irradiation dose of 35 Gy on the left mandible, and eight were used as the nonirradiated control group. Read More

J Surg Oncol 2020 Jun 9. Epub 2020 Jun 9.

Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, the Netherlands.

Background And Objectives: To determine locoregional recurrence rate (LRR) and disease-specific survival (DSS) following marginal vs segmental mandibulectomy.

Methods: Included were 210 patients, who had marginal or segmental mandibulectomy between 2000 and 2017. Marginal resection was performed when complete removal of the tumor was deemed feasible on the condition that at least 1 cm bone height of the inferior border of the mandible could be preserved. Read More

Med Pharm Rep 2020 Apr 22;93(2):195-199. Epub 2020 Apr 22.

Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India.

Objectives: To identify the potential risk factors for the occurrence of osteoradionecrosis (ORN) of the jaws among patients who have been treated with radiotherapy for head and neck malignancy.

Methods: The study comprised of 231 patients treated with radiotherapy for head and neck malignancy at a tertiary referral center. The following details were recorded for each patient: age, gender, histopathological diagnosis, clinical staging, tumor site, treatment modality, radiation dose, radiation field, number of fractions, type of accelerator used, radiation area and duration of follow-up. Read More

Int J Oncol 2020 Jul 23;57(1):213-222. Epub 2020 Apr 23.

Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China.

Advanced osteoradionecrosis (ORN) is one of the most serious complications in patients with head and neck cancer, resulting in poor prognosis. Numerous studies have therefore focused on the pathogenesis and interventions of ORN early stage. The present study aimed to investigate whether α2‑macroglobulin (α2M) could prevent early‑stage jaw osteoradionecrosis caused by radiotherapy (RT). Read More

SAGE Open Med Case Rep 2020 2;8:2050313X20915415. Epub 2020 Apr 2.

Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Perforation of the larynx is very rare but may result in severe airway complications that include pneumothorax, pneumonia, mediastinitis, and retropharyngeal abscess. If conservative treatment fails, aggressive treatments including reconstructive surgery with pedicle flap are considered. Negative pressure wound therapy has been used for large skin defects, necrotizing fasciitis, pharyngocutaneous fistula, stoma dehiscence, osteoradionecrosis of the mandible, chyle fistula, flap failure, and lymphangioma in the field of head and neck surgery. Read More

J Oral Maxillofac Surg 2020 Jun 11;78(6):1034.e1-1034.e10. Epub 2020 Feb 11.

Assistant Professor, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX. Electronic address:

Purpose: Osteoradionecrosis (ORN), a potentially debilitating complication of maxillofacial radiation, continues to present a challenging clinical scenario, with limited treatment options that often fail. Translational animal models that can accurately mimic the human characteristics of the condition are lacking. In the present pilot study, we aimed to characterize the effects of radiation on the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) pharmacokinetic parameters in a rabbit model of compromised maxillofacial wound healing to determine its potential as a translational model of ORN. Read More

Clin Ter 2020 Mar-Apr;171(2):e110-e113

Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Osteoradionecrosis (ORN) is a well-recognized, debilitating complication of radiotherapy for patients with head and neck cancer. There is no universally accepted treatment for ORN of the jawbones. We report on a case of refractory mandibular ORN treated by sequestrectomy of mandible and autogenous transplantation of fat graft combined with platelet-rich fibrin (PRF). Read More

Head Neck 2020 Apr 3;42(4):794-802. Epub 2020 Jan 3.

Laboratoire des sarcomes osseux et remodelage des tissus calcifiés, Unité Mixte de Recherche, Faculté de Médecine, 1 rue Gaston Veil, Nantes Cedex, France.

There is no recommendation regarding the timing for implant surgery in patients with head and neck cancer (HNC) who require postoperative radiation therapy (RT). This systematic review focused on the literature about the outcomes of implants placed during ablative surgery in patients with HNC who underwent postoperative RT. Implants placed after radiation therapy and implants placed in reconstructed jaws were excluded. Read More

Am J Otolaryngol 2020 May - Jun;41(3):102343. Epub 2019 Nov 12.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan. Electronic address:

Laryngoscope 2019 Nov 20. Epub 2019 Nov 20.

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Center Gabriel Montpied, Clermont-Ferrand, France.

Objectives/hypothesis: PENTOCLO treatment, associating pentoxifylline, tocopherol, and clodronate, resolves radiation-induced fibrosis. The main aim of the present study was to prospectively assess efficacy in mandibular osteoradionecrosis (ORN).

Study Design: Prospective cohort study. Read More

J Korean Assoc Oral Maxillofac Surg 2019 Oct 30;45(5):260-266. Epub 2019 Oct 30.

Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.

Objectives: Dental implants shorter than 8 mm, called short dental implants (SDIs), have been considered to have a lower success rate than standard length implants. But recent studies have shown that SDIs have a comparable success rate, and implant diameter was more important for implant survival than implant length. Also, SDIs have many advantages, such as no need for sinus lifting or vertical bone grafting, which may limit use in medically compromised patients. Read More

Clin Radiol 2020 Jan 4;75(1):46-50. Epub 2019 Nov 4.

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

Aim: To investigate the diagnostic ability of maximum standardised uptake value (SUV) at combined single-photon-emission computed tomography/computed tomography (SPECT/CT) for the evaluation of osteonecrosis of the jaw.

Materials And Methods: Seven patients with mandibular osteonecrosis (three osteoradionecrosis, three medication-related osteonecrosis of the jaw (MRONJ), and one rheumatoid arthritis) underwent SPECT/CT at 4 hours after injection of technetium 99m hydroxymethylene diphosphonate. The SPECT/CT parameters SUV were compared for the osteonecrosis with normal mandible. Read More

World J Plast Surg 2019 Sep;8(3):401-405

Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.

The main complication in patients with combined treatment of head, neck, mandibular and maxillary tumors is osteoradionecrosis, which appears after radiation therapy. Radiation therapy is widely used to treat cancer, but growing concern is related to the risk of osteoradionecrosis after treatment. This can occur after radiation therapy. Read More

Anticancer Res 2019 Oct;39(10):5689-5693

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

Background/aim: To evaluate the association between osteoradionecrosis (ORN) of the mandible and stenosis of the external carotid artery after radiation therapy (RT) for head and neck cancer.

Patients And Methods: The computed tomography images of 42 patients (36 men, six women; median age, 64.5 years) treated with RT for head and neck cancer between January 2011 and December 2015 were reviewed. Read More

Undersea Hyperb Med 2019 Jun-Jul-Aug - Third Quarter;46(4):399-408

Past Chairman of Oral and Maxillofacial Surgery Wilford Hall USAF Medical Center, Lackland AFB, Texas U.S.

Mr. Richard Clarke presents in this Journal his arguments against continued application of hyperbaric oxygen (HBO2) therapy to the pre-extraction neoadjuvant treatment or the treatment of frank mandibular ORN. In the same article he advocates a promising renewed interest in HBO2 as a radiosensitizer. Read More

Undersea Hyperb Med 2019 Jun-Jul-Aug - Third Quarter;46(4):385-397

National Baromedical Services, Columbia, South Carolina, U.S.

Over the past four decades, hyperbaric oxygen (HBO2) therapy has played a prominent role in both the prevention and treatment of mandibular osteoradionecrosis (ORN). It has done so on the strength of laboratory observations and clinical reports, yet only limited efficacy data. This dual role has come under increasing scrutiny in the modern radiotherapy (RT) and surgical eras. Read More

J Stomatol Oral Maxillofac Surg 2020 Apr 30;121(2):124-128. Epub 2019 Aug 30.

Department of Maxillo-Facial Surgery, University Hospital of Amiens, Avenue Laennec, 80000 Amiens, France; EA CHIMERE, Picardie Jules Verne University, Avenue Laennec, 80000 Amiens, France.

Introduction: The chronic complications of bone free-flap revascularization surgery are mainly characterized by skin fistulization of the osteosynthesis material, which sometimes leads to reactivation of the osteoradionecrotic phenomenon. The objective of the study is to evaluate the benefit of mandibular basilar edge preservation in bone reconstructive surgery in irradiated areas performed for the treatment of advanced mandibular osteoradionecrosis.

Materials And Methods: A retrospective monocentric study conducted between 2003 and 2018 including all patients undergoing revascularization surgery for the treatment of advanced osteoradionecrotic lesion with respect to the basilar margin was conducted. Read More

J Stomatol Oral Maxillofac Surg 2020 Jun 30;121(3):242-247. Epub 2019 Aug 30.

Université de Lille, CHU de Lille, INSERM, Department of Oral and Maxillofacial Surgery, U1008 - Controlled Drug Delivery Systems and Biomaterials, 59000 Lille, France.

Introduction: Ginestet introduced the first external device used to fix the mandible in 1936. In 1949, Morris introduced a biphasic fixation device. This "Joe Hall Morris fixation" design led to use of a self-crafted external fixator based on pins connected by a breathing tube filled with dental resin. Read More

J Biomech 2019 Oct 19;95:109320. Epub 2019 Aug 19.

Klinik für Mund-, Kiefer- und Gesichtschirurgie, University Hospital Basel, Spitalstr. 21, CH-4031 Basel, Switzerland; Hightech Research Center of Cranio-Maxillofacial Surgery (HFZ), University Hospital Basel, Gewerbestrasse 14, CH-4123 Allschwil, Switzerland.

Serious mandibular diseases such as tumor or osteonecrosis often require segmental or marginal mandibulectomy, the latter with improved outcome thanks to preserved mandibular continuity. Nevertheless, gradual osteolytic and/or osteosclerotic skeletal changes frequently indicate repetitive resections. Based on the fundamental adaptivity of bone to mechanical loads, the question arose whether resection-related anatomical alterations trigger relevant pathological skeletal adaptations. Read More

J Natl Cancer Inst Monogr 2019 08;2019(53)

Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

The deleterious effects of head and neck radiation on bone, with osteoradionecrosis (ORN) as the major disabling side effect of head and neck cancer treatment, are difficult to prevent and hard to treat. This review focuses on the current state of the science regarding the pathobiology, clinical impact, and management of ORN. With regard to the pathobiology underlying ORN, it is not yet confirmed whether the current radiation schedules by 3-dimensional conformal radiotherapy and intensity modified radiotherapy result in an unchanged, decreased, or increased risk of developing ORN when compared with conventional radiation treatment, the main risk factor being the total radiation dose delivered on any clinically significant surface of the mandible. Read More

Eur Arch Otorhinolaryngol 2019 Dec 14;276(12):3443-3452. Epub 2019 Aug 14.

Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.

Purpose: A combination of pentoxifylline (PTX) and tocopherol (TP) is believed to reduce chronic fibrosis and induce bone healing in osteoradionecrosis (ORN) of the mandible, but evidence of its therapeutic effectiveness for cortical bone is lacking. This study was designed to determine the effect of combined PTX and TP (PTX + TP) on mandibular cortical bone remodeling in a rat model of ORN, using micro-CT and histological analysis.

Methods: Forty-eight 8-week-old male Sprague-Dawley rats were randomly divided into irradiated (n = 40) and non-irradiated (n = 8) groups. Read More

Curr Opin Otolaryngol Head Neck Surg 2019 Oct;27(5):401-406

Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, Galveston, Texas, USA.

Purpose Of Review: To describe current standard of care for osteoradionecrosis (ORN) of the mandible and report possible future trends.

Recent Findings: Cutting guides may be used to reduce surgical time and possibly improve outcomes. There has also been recent investigation into the use of pentoxifylline and tocopherol or pentoxifylline, tocopherol and clodronate (a well known conservative medial regime) as a prevention for development of ORN after dental extractions and the first randomized controlled study is upcoming. Read More

Acta Oncol 2019 Oct 31;58(10):1373-1377. Epub 2019 Jul 31.

Department of Oncology, Odense University Hospital , Odense , Denmark.

The project aimed at determining the incidence of mandibular osteoradionecrosis (ORN) after radiotherapy, possible risk factors, and mandibular dose-volume effects in a large cohort of head and neck cancer patients (HNC). The cohort consisted of 1224 HNC patients treated with 66-68 Gy in 2007-2015 predominantly with IMRT. ORN cases were defined from clinical observations at follow-up and through hospital code diagnostics after oral-maxillofacial surgery and cross-checked with the national Danish Head and Neck Cancer database. Read More

Int J Oral Maxillofac Surg 2020 Mar 26;49(3):411-419. Epub 2019 Jul 26.

Department of Oral & Maxillofacial - Head & Neck Oncology, 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.

Osteoradionecrosis of the mandible (MORN) is one of the most devastating complications caused by radiation therapy in the head and neck region. It is characterized by infection and chronic necrosis of the mandible as the main manifestation. Clinically, MORN-related symptoms include swelling, pain, dysphagia, trismus, masticatory or speech disorders, refractory orocutaneous fistula, bone exposure, and even pathological fracture. Read More

Am J Otolaryngol 2019 Nov - Dec;40(6):102262. Epub 2019 Jul 8.

Head and Neck Institute, Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic, Cleveland, OH, United States of America. Electronic address:

Objectives: To evaluate the use of the anterolateral thigh fascia free flap for use in neovascularization of mandibular bone in moderate osteoradionecrosis (ORN). All patients had ORN secondary to prior radiation therapy that was not severe enough to warrant segmental resection and reconstruction.

Study Design: Case series. Read More

Strahlenther Onkol 2019 Sep 2;195(9):819-829. Epub 2019 Jul 2.

Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Purpose: To assess radiotherapy (RT) outcomes in patients with gingival carcinoma and growth up to or involvement of the lower jaw bone.

Methods: This was a retrospective analysis of 51 patients with squamous cell carcinomas of the gingiva. Patients received definitive (group 1, 31. Read More

Int J Oral Maxillofac Surg 2019 Nov 18;48(11):1398-1404. Epub 2019 Jun 18.

Department of Maxillo-Facial Surgery, University Hospital of Amiens, Avenue Laennec, 80000 Amiens, France; EA CHIMERE, Picardie Jules Verne University, Avenue Laennec, 80000 Amiens, France.

Mandibular osteoradionecrosis (mORN) is a severe complication of head and neck irradiation. International consensus on the management of mORN is currently lacking. The present study sought to evaluate the effectiveness and benefits of early reconstructive surgery (resection of the diseased bone and immediate reconstruction with a free flap) in treatment-refractory mORN. Read More

J Plast Reconstr Aesthet Surg 2019 Sep 24;72(9):1478-1483. Epub 2019 May 24.

Department of Plastic and Recontstructive Surgery, Royal Melbourne Hospital. 300 Grattan Street, Parkville, Victoria 3050, Australia.

Background: Bony free flaps are used to reconstruct head and neck cancer defects. The most commonly used flaps are the free fibula flap and the deep circumflex iliac artery (DCIA) flap. Radiotherapy may be given post-operatively to prevent cancer recurrence. Read More

Br J Oral Maxillofac Surg 2019 07 16;57(6):550-556. Epub 2019 May 16.

Department of Maxillo-Facial Surgery, University Hospital of Amiens, Avenue Laennec, 80000 Amiens, France; EA CHIMERE, Picardie Jules Verne University, Avenue Laennec, 80000 Amiens, France. Electronic address:

Mandibular osteoradionecrosis (ORN) is one of the most serious complications of radiotherapy of the head and neck, and is characterised by hypoxia, hypovascularisation, and hypocellularity. Periosteal free flaps have intrinsic osteogenic, and extrinsic neoangiogenic, properties that are related to the periosteum. Our objective was to present our experience with the use of periosteal free flaps in the treatment of ORN (Notani class I or II) that are refractory to conservative management or have a large area of bone (≥2 cm) exposed. Read More

Laryngoscope 2019 12 10;129(12):E428-E433. Epub 2019 May 10.

Department of Medicine, Division of Medical Oncology, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, University of Washington, Seattle, Washington.

Immune checkpoint inhibitors have demonstrated activity in recurrent/metastatic head and neck squamous cell cancer, but less is known regarding their long-term sequelae. We describe four patients who, after complete responses to anti-PD-1 therapy, developed complications requiring surgical intervention. Patient 1 is a 57-year-old female whose marked tumor regression exposed some mandibular hardware. Read More

Int J Oral Maxillofac Surg 2019 Aug 10;48(8):1022-1027. 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 07 7;104(3):530-539. 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 03 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 Jul 26;25(5):1344-1351. Epub 2019 Mar 26.

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 2020 01 20;130(1):101-107. 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 12 13;87:177-178. Epub 2018 Nov 13.

Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, India.

Oral Oncol 2018 12 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

Head Neck 2019 01 4;41(1):30-36. Epub 2018 Dec 4.

Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

Background: The scapular tip free flap (STFF) is becoming more popular for oromandibular reconstruction. This article reviewed the early and late outcomes in a larger series over 9 years.

Methods: We conducted a retrospective review of all consecutive patients who underwent oromandibular reconstruction using the STFF at London Health Sciences Centre. Read More