Osteoradionecrosis (ORN) of the jaws is most commonly defined clinically as an area of previously irradiated, devitalized, exposed bone that fails to heal over a period of three to six months, in the absence of local neoplastic disease. It is thought to be caused by radiation-induced fibro-atrophic tissue injury. 1 ORN is associated with considerable morbidity and has important ramifications for the quality of life of cancer survivors. 2, 3 Principal manifestations include pain, and, more rarely, dysesthesia and anesthesia. 4 These may be further complicated by secondary infection and fistula formation, as well as dysgeusia, dysphagia, dyspnea, xerostomia, pathologic fracture and mechanical impairment of speech. 4 Many classification systems have been devised in order to stratify the wide spectrum of clinical presentations of ORN; however, their adoption has been far from universal and none has been validated with large-scale clinical trials, 5 posing difficulties for the comparison of controlled interventions and potential disparities in reporting rates.
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Original Release Date: 2009; Review Date: 2019; Expiration Date: 2022