To provide a case presentation of osteoradionecrosis (ORN)

Osteoradionecrosis is a rare but significant late complication observed in pateints treated with radiation for head and neck cancers.1 It is characterised by loss of bone viability and healing defect that is induced by radiation.2 The mandible is more commonly affected than the maxilla as it is ofen involved in radiation fields.2 MJ, a 67 year old female presented with two weeks history of increasing left jaw pain. The pain was exacerbated by motion, and she reported limited mouth opening which limited her oral intake....

OPG: Left maxillary alveolar bone resorption CT head and neck:Undisplaced fracture of left mandible at the left mandibular angle. No soft tissue masses. PET whole body: Moderate metabolism in defect in left mandible reflecting radiation necrosis. Nil evidence of widespread disease. MJ was subsequently diagnosed with severe osteoradionecrosis of the left mandible.

The development of ORN has been associated with several risk factors such as poor oral health status, radiation dose, pre-radiotherapy surgery, chemotherapy, alcohol intake and tobacco use.1 Radiation is the main etiologic factor in a dose dependent manner.3 ORN is rare with a conventional radiation dose of less than 60 Gy while rates are higher in those that receive more than 60Gy (12%).3 The use of IMRT has been associated with a lower risk of ORN and lower severity if it develops.3 Management options for...

1. Kubota H, Miyawaki D, Mukumoto N, Ishihara T, Matsumura M, Hasegawa T, Akashi M, Kiyota N, Shinomiya H, Teshima M, Nibu Kl. Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma. Radiation oncology. 2021 Dec; 16(1) 1-1 2. Pereira IF, Firmino RT, Meira HC, Vasconcelos BC. Osteoradionecrosis prevalence and associated factors: A ten years retrospective study. Medicina oral, patologia oral y cirugia bucal. 2018 Nov;23(6):e633. 3. Gevorgyan A, Wong K, Poon I. Blanas N, Enepekides DJ, Higgins...