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Osteoradionecrosis of the Jaw (ORN)

Non-healing exposed irradiated jaw bone after head-and-neck radiotherapy, often triggered by trauma or extraction.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Osteoradionecrosis of the Jaw (ORN)?

Osteoradionecrosis (ORN) of the jaw is a chronic non-healing exposure of irradiated jawbone occurring 3 months or more after radiotherapy without evidence of recurrent or persistent tumor.

It results from radiation-induced damage to bone vasculature and cellularity (hypovascular, hypocellular, hypoxic tissue), reduced healing capacity after dental trauma, and microbial contamination. The mandible is far more commonly affected than the maxilla due to denser bone and limited collateral blood supply.

Major risk factors include radiation dose >60 Gy, dental extractions after radiotherapy without precautions, poor oral hygiene, smoking, alcohol, malnutrition, and concomitant chemotherapy. Preventive dental evaluation and pre-radiotherapy extractions reduce risk.

Symptoms

Exposed bone in the mouth lasting >3 months
Pain and tenderness in jaw or oral mucosa
Swelling, pus discharge, halitosis
Pathologic fracture of mandible (advanced)
Trismus (limited mouth opening)
Orocutaneous fistula (severe)
Tooth mobility or loss in irradiated area

Risk Factors

Radiotherapy dose >60 Gy to the jaw
Dental extraction after radiotherapy without precautions
Poor oral hygiene and active dental disease
Smoking and alcohol use
Concomitant chemotherapy
Malnutrition and immunosuppression
Diabetes mellitus

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Exposed bone in the mouth lasting more than 3 months
  • Persistent jaw pain after head-and-neck radiotherapy
  • Non-healing socket after extraction
  • Halitosis with oral pus discharge
  • Mandibular fracture or instability
  • Pre-radiotherapy dental evaluation needed
  • Severe trismus or facial swelling

Treatment Methods

01
Strict oral hygiene and chlorhexidine rinses
02
Pre-radiotherapy comprehensive dental evaluation and extractions
03
Local debridement and removal of necrotic bone
04
Long-term antibiotics for secondary infection
05
Pentoxifylline-tocopherol regimen (PENTOCLO)
06
Hyperbaric oxygen therapy (selected cases)
07
Segmental mandibulectomy with vascularized free flap reconstruction in advanced ORN

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Impacted Tooth

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An impacted tooth — most often a wisdom tooth — has not erupted fully and remains in the jaw bone or gum. It can lead to pericoronitis, caries and cysts.

Dental Implants

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A dental implant is a titanium screw placed in the jawbone that supports a crown, bridge or denture, providing the closest possible function and aesthetics to a natural tooth.

Teeth Whitening

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Orthodontics

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Orthodontics is the dental specialty that corrects the alignment of the teeth and jaws, providing both aesthetic and functional benefits at any age, from childhood through adulthood.

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Gingival recession is the apical displacement of the gingival margin with exposure of the root surface. It may be localized or generalized and results from mechanical trauma, periodontal disease, thin biotype or anatomic factors. Recession can cause root sensitivity, caries and aesthetic concerns; management includes cause elimination and surgical root coverage when indicated.

Bad Breath (Halitosis)

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Halitosis is a chronic problem that affects a substantial part of the population. It is most often of oral origin and can interfere with social interactions.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.