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The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

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-atrophi...

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Autores principales: Huang, Nan, Wang, Peihan, Gong, Ping, Huang, Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033216/
https://www.ncbi.nlm.nih.gov/pubmed/36968640
http://dx.doi.org/10.1155/2023/1440889
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author Huang, Nan
Wang, Peihan
Gong, Ping
Huang, Bo
author_facet Huang, Nan
Wang, Peihan
Gong, Ping
Huang, Bo
author_sort Huang, Nan
collection PubMed
description 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.
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spelling pubmed-100332162023-03-23 The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis Huang, Nan Wang, Peihan Gong, Ping Huang, Bo J Oncol Review Article 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. Hindawi 2023-03-15 /pmc/articles/PMC10033216/ /pubmed/36968640 http://dx.doi.org/10.1155/2023/1440889 Text en Copyright © 2023 Nan Huang et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Huang, Nan
Wang, Peihan
Gong, Ping
Huang, Bo
The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis
title The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis
title_full The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis
title_fullStr The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis
title_full_unstemmed The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis
title_short The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis
title_sort progress in reconstruction of mandibular defect caused by osteoradionecrosis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033216/
https://www.ncbi.nlm.nih.gov/pubmed/36968640
http://dx.doi.org/10.1155/2023/1440889
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