TY - JOUR
T1 - New perspectives on the conservative management of osteoradionecrosis of the mandible: A literature review
AU - Costa, Diogo Alpuim
AU - Costa, Tiago Porfirio
AU - Netto, Eduardo Carlinhos
AU - Joaquim, Natercia
AU - Ventura, Isabel
AU - Pratas, Ana Cristina
AU - Winckler, Patricia
AU - Silva, Ines Pires
AU - Pinho, Ana Catarina
AU - Sargento, Isabel Goulao
AU - Guerreiro, Francisco Gamito
AU - Moreira, Antonio Rita
PY - 2016/11
Y1 - 2016/11
N2 - Over the last decades, several therapeutic options were considered in the treatment of the osteoradionecrosis (ORN) of the mandible, including supportive measures, ultrasound therapy, corticosteroids, hyperbaric oxygen, surgical resection with reconstruction, and, more recently, drugs capable of reversing the fibroatrophic process. Once established, the ORN does not spontaneously disappear and a standard treatment has not yet been defined. The clear clinical effectiveness of hyperbaric oxygen therapy (HBOT) varies according to the literature and there are some economic/logistic issues to be considered; the triplet tocopherol/pentoxifylline/clodronate demands greater evidence from randomized clinical trials and also resilience from the patient, given the long treatment duration and its possible side effects. Controversy around the ideal treatment of the initial stage ORN of the mandible persists. More rigorous randomized prospective trials are essential. The purpose of this article was to review the relevant literature on the physiopathology of ORN of the mandible and discuss the new perspectives of its conservative treatment. (C) 2016 Wiley Periodicals, Inc.
AB - Over the last decades, several therapeutic options were considered in the treatment of the osteoradionecrosis (ORN) of the mandible, including supportive measures, ultrasound therapy, corticosteroids, hyperbaric oxygen, surgical resection with reconstruction, and, more recently, drugs capable of reversing the fibroatrophic process. Once established, the ORN does not spontaneously disappear and a standard treatment has not yet been defined. The clear clinical effectiveness of hyperbaric oxygen therapy (HBOT) varies according to the literature and there are some economic/logistic issues to be considered; the triplet tocopherol/pentoxifylline/clodronate demands greater evidence from randomized clinical trials and also resilience from the patient, given the long treatment duration and its possible side effects. Controversy around the ideal treatment of the initial stage ORN of the mandible persists. More rigorous randomized prospective trials are essential. The purpose of this article was to review the relevant literature on the physiopathology of ORN of the mandible and discuss the new perspectives of its conservative treatment. (C) 2016 Wiley Periodicals, Inc.
KW - osteoradionecrosis
KW - mandible
KW - physiopathology
KW - conservative management
KW - radiation-induced fibrosis
U2 - 10.1002/hed.24495
DO - 10.1002/hed.24495
M3 - Review article
C2 - 27240248
VL - 38
SP - 1708
EP - 1716
JO - HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
JF - HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
SN - 1043-3074
IS - 11
ER -