Managing Mandibular Osteoradionecrosis

Otolaryngology, Год журнала: 2024, Номер unknown

Опубликована: Сен. 27, 2024

Abstract Objective Mandibular osteoradionecrosis (MORN) is a morbid complication of head and neck radiation therapy. Recent advances in surgical medical therapies underscore the need for shift traditional treatment paradigms disease grading system that can guide appropriate management. Data Sources Pubmed/MEDLINE. Review Methods We conducted detailed review publications related to MORN, specifically focusing on its staging management techniques. Articles meeting inclusion criteria were synthesized into final narrative review. Conclusion There has been paradigm away from hyperbaric oxygen therapy MORN. Growing evidence efficacy pentoxifylline tocopherol early‐stage novel techniques manage moderate late‐stage warrant an updated stratification which proposed. Implications Practice This summarizes clinical established therapeutic modalities currently available treating emphasizing significant achieved over last decade. It introduces contemporary algorithm incorporates traditional, evidence‐supported with effective early intervention strategies.

Язык: Английский

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The initial implementation of the transverse bone transport technique in the post-radiation region of the mandible. A pre-clinical in vivo study

BMC Oral Health, Год журнала: 2024, Номер 24(1)

Опубликована: Ноя. 25, 2024

To link the treatment of radiation injury with angiogenesis, and to design seek a new therapeutic technique for prevention injury.

Язык: Английский

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Mandibular dose-volume predicts time-to-osteoradionecrosis in an actuarial normal-tissue complication probability (NTCP) model: External validation of right-censored clinico-dosimetric and competing risk application across international multi-institutional observational cohorts and online graphical user interface clinical support tool assessment

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2024, Номер unknown

Опубликована: Авг. 20, 2024

Abstract Background Existing studies on osteoradionecrosis of the jaw (ORNJ) have primarily used cross-sectional data, assessing risk factors at a single time point. Determining time-to-event profile ORNJ has important implications to monitor oral health in head and neck cancer (HNC) long-term survivors. Methods Demographic, clinical dosimetric data were retrospectively obtained for observational cohort 1129 patients with HNC treated radiotherapy (RT) The University Texas MD Anderson Cancer Center. was diagnosed 198 (18%). A multivariable logistic regression analysis forward stepwise variable selection identified significant predictors ORNJ. These then train Weibull Accelerated Failure Time (AFT) model, which externally validated using an independent 265 (92 cases 173 controls) Guy’s St. Thomas’ Hospitals. Findings Our model that each unit increase D25% is significantly associated 12% shorter (Adjusted Ratio [ATR] 0·88, p<0·005); pre-RT dental extractions 27% faster (ATR 0·73, p=0·13) onset ORNJ; male experienced 38% 0·62, p = 0·11). demonstrated strong internal calibration (integrated Brier score 0·133, D-calibration p-value 0.998) optimal discrimination 72 months (Harrell’s C-index 0·72). also showed good generalization cohort, despite slight drop performance. Interpretation This study first demonstrate direct relationship between radiation dose onset, providing novel characterization impact delivered not only probability late effect (ORNJ), but conditional during survivorship. Funding work supported by various funding sources including NIH, NIDCR, NCI, NAPT, NASA, BCM, Affirmed Pharma, CRUK, KWF Dutch Society, NWO ZonMw, Apache Corporation.

Язык: Английский

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Are prophylactic antibiotics effective in preventing osteoradionecrosis after high-risk dental extractions?

Evidence-Based Dentistry, Год журнала: 2024, Номер unknown

Опубликована: Сен. 23, 2024

Язык: Английский

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Reply to E. Topkan et al

Journal of Clinical Oncology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 3, 2024

Язык: Английский

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