The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

Author:

Huang Nan1ORCID,Wang Peihan1ORCID,Gong Ping2ORCID,Huang Bo12ORCID

Affiliation:

1. West China School of Stomatology and National Center of Stomatology, Sichuan University, Chengdu 610041, China

2. State Key Laboratory of Oral Diseases and General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Abstract

Osteoradionecrosis (ORN) is described as a disease with exposed, nonviable bone that fails to heal spontaneously or by means of conservative treatment after radiotherapy in at least 3 months. Though traditional theories in the early stage including hypoxic-hypocellular-hypovascular and fibro-atrophic in addition to new findings such as ferroptosis were put forward to explain the mechanisms of the osteoradionecrosis, the etiology of ORN is still unclear. With the high rate of occurrence in the head and neck area, especially in the mandible, this disease can disrupt the shape and function of the irradiated area, leading to a clinical presentation ranging from stable small areas of asymptomatic exposed bone to severe progressive necrosis. In severe cases, patients may experience pain, xerostomia, dysphagia, facial fistulas, and even a jaw defect. Consequently, sequence therapy and sometimes extensive surgery and reconstructions are needed to manage these sequelae. Treatment options may include pain medication, antibiotics, the removal of sequesters, hyperbaric oxygen therapy, segmental resection of the mandible, and free flap reconstruction. Microanastomosed free-flaps are considered to be promising choice for ORN reconstruction in recent researches, and new methods including three-dimensional (3-D) printing, pentoxifylline, and amifostine are used nowadays in trying increase the success rates and improve quality of the reconstruction. This review summarizes the main research progress in osteoradionecrosis and reconstruction treatment of osteoradionecrosis with mandibular defect.

Funder

National Outstanding Youth Science Fund Project of National Natural Science Foundation of China

Publisher

Hindawi Limited

Subject

Oncology

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