Conservative Approach of a Severe Case of Osteoradionecrosis of the Mandible- Case Report

Abstract

Osteoradionecrosis (ORN) of the jaw is a severe, complex, and multifactorial complication of radiotherapy (RT) for head and neck cancers. Most cases of ORN develop during the first 3 years with a peak between 6 months and 2 years after completion of RT however the patient is considered at risk of developing this condition many years later. The management of ORN is usually based on conventional medical care by focusing on comorbidity factors, However, in some refractory ORN cases, the condition requires extensive surgical resection. Based on the “the radiation-induced fibro-atrophic theory” introduced by Delanian, a new conservative approach of ORN seems to be promising by combining antioxidant agents: pentoxifylline and Tocopherol (PtxE) in the treatment of severe cases of ORN. The aim of this paper was to report the case of a severe case of ORN of the mandible stabilized by a conservative approach combining antibiotics, antiseptic agent as well as antioxidant therapy (PtxE), and to discuss the efficacy of this approach.