Osteonecrosis of the mandible after radiation therapy for cancer of the head and neck may occur more frequently if certain risk factors are present.
Risk factors for mandibular osteoradionecrosis:
(1) high dose external beam radiation
(2) cancer in the oral cavity (risk is low for cancers of the larynx or hypopharynx)
(3) pre-existing defect in the mandible
(4) malnutrition
(5) continued excessive use of tobacco and alcohol (may correlate with poor dentition or frequency of intra-oral lesions)
(6) poor dentition or poorly fitting dentures (risk is lowest if edentulous)
(7) tumor growth close to or involving the mandible
A patient with poor dentition whose teeth will be in the radiation field should:
(1) have the teeth extracted prior to radiation therapy
(2) wait 3 weeks after the extraction before starting the radiation therapy
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Purpose: To determine if a patient with a cancer of the head and neck is at risk for mandibular osteoradionecrosis (ORN) if irradiated.
Specialty: Hematology Oncology, Otolaryngology
Objective: risk factors, adverse effects
ICD-10: T66,
