Osteoradionecrosis (ORN) of the jaws is a serious complication of radiotherapy of head and neck malignancies. Different assumptions about its occurring, risk factors and possible therapeutical modalities exist, but the clinical outcome of such patients is still not on the desired level. This article presents a clinical case of ORN of the mandible, occurring with exposed and infected bone, necrotic process that extended through all the mandible body, as well as cutaneous fistula. The first site of ORN was detected 2 years after radiotherapy for oral cancer, with the second one detected 3 and a half years after radiotherapy. In both, the reason for exposing the bone was local trauma due to tooth extraction. Due to the stage of the condition, a decision for surgical treatment accompanied with antibiotics was made.
It is very important and critical for irradiated patients and patients with osteoradionecrosis to perform appropriate oral hygiene and frequent dental checks. Establishing protocols for prevention and treatment, but involving some new strategies regarding to this condition, are strongly recommended.
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