A osteonecrose dos maxilares associada a medicamentos é uma doença que causa necrose do tecido ósseo dos maxilares — maxila e mandíbula — em um indivíduo que faz uso regular de medicações que aumentam o risco da patologia na ausência de um tratamento prévio com radiação. Pode levar a complicações cirúrgicas com a ausência de cicatrização tecidual após cirurgias orais, cirurgias periodontais ou tratamento endodôntico.
Introdução
O que você precisa saber de cara
Necrose óssea da mandíbula após radioterapia na região de cabeça e pescoço, caracterizada por dor, exposição óssea e infecção. Pode levar a fraturas patológicas e dificuldade de cicatrização.
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Entender a doença
Do básico ao detalhe, leia no seu ritmo
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
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Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Osteorradionecrose da mandíbula
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Publicações mais relevantes
Use of Nerve Tape for Sutureless Neurorrhaphy With Nerve Allograft in Repair of the Inferior Alveolar Nerve.
Reconstruction of the inferior alveolar nerve (IAN) following segmental mandibulectomy presents microsurgical challenges. Traditional neurorrhaphy using microsutures can be technically demanding, time-consuming, and may induce local trauma to the nerve graft. The authors report the case of a 52-year-old male with osteoradionecrosis of the mandible who underwent segmental mandibulectomy and immediate reconstruction of the IAN using an allogeneic nerve graft. For restoration of IAN continuity, a processed nerve allograft (Avance Nerve Graft, Axogen, Alachua, FL) was secured using Nerve Tape (BioCircuit Technologies Inc, Atlanta, GA), a sutureless coaptation device constructed with biological scaffold material and nitinol microhook technology to secure and align nerve ends. This product is composed of acellularized porcine small intestinal submucosal (SIS) tissue, like the Axoguard wrap, providing comparable handling and integration properties. This approach allowed rapid, atraumatic indirect neurorrhaphy of the IAN. Postoperative follow-up will be performed to determine whether progressive neurosensory recovery has occurred. Nerve Tape offers a promising alternative for nerve coaptation in trigeminal nerve reconstruction.
What Is the Effectiveness of Tocopherol and Pentoxifylline in the Treatment of Osteoradionecrosis of the Mandible?
This article reviews the current literature on the use of pentoxifylline and tocopherol for the medical management of osteoradionecrosis of the mandible after head and neck radiotherapy.
Management of Osteoradionecrosis in Jaws.
Osteoradionecrosis of the mandible refers to necrosis of bone and often with surrounding tissues after radiotherapy. This is often compounded by chronic infection, leading to debilitating outcomes on the patient's quality of life. In this article, we discuss the incidence, risk factors, diagnosis, staging, pathophysiology, and management of this condition. We discuss our experience in managing this condition, which can vary depending on severity and patient factors, when taking into account approaches ranging from conservative to surgical resection and free flap reconstruction.
Hyperbaric Oxygen Effects on Surgical Outcomes in Mandibular Osteoradionecrosis Requiring Segmental Resection and Free Tissue Transfer.
Background: Treatment of head and neck cancer with radiation can cause osteoradionecrosis of the mandible (MORN), requiring removal of nonviable bone and free flap reconstruction. Objective: To compare surgical outcomes in patients with MORN treated with free tissue transfer who received hyperbaric oxygen therapy (HBO) to those who did not, measured by flap failure, nonunion, plate exposure, and postoperative infections. Methods: This retrospective cohort study evaluated 311 patients with advanced MORN treated at a single tertiary care academic center with segmental mandibulectomy and free flap reconstruction. One group received HBO preoperatively and postoperatively; the other group did not. Postoperative complications were compared using chi-square test or Fisher's exact test. Results: This study included 311 patients, 131 HBO group (74% male, 26% female, mean age 75.6 years), 180 in the non-HBO group (73% male, 27% female, mean age 76.3 years). Postoperative metrics included; complete flap failure (HBO = 4, non-HBO = 2), partial flap failure (HBO = 2, non-HBO = 3), nonunion (HBO = 10, non-HBO = 14) exposed plate (HBO-7, non-HBO = 8), wound infections treated surgically (HBO = 2, non-HBO = 7), wound infections treated with antibiotics alone (HBO = 5, non-HBO = 12). No differences were identified between groups. Conclusion: We found no difference in rates of postoperative complications between the HBO group and the non-HBO group.
Establishment of an Osteoradionecrosis Model and its Mechanism Via Single Ionizing Radiation Exposure.
The aim of this study was to establish a reliable model of osteoradionecrosis of the mandible in New Zealand white rabbits and systematically examine the impacts of different radiation doses on mandibular tissue, as well as to appraise the inducing role of tooth extraction in the pathogenesis of the disease. In this research, 16 New Zealand white rabbits were randomly allocated to the control group, the 16Gy group, the 18Gy group, and the 20Gy group with a single high-dose radiation. Two weeks after radiotherapy, the teeth were extracted, and the animals were sacrificed four weeks later. Micro CT, scanning electron microscopy, HE staining, Masson staining, TRAP staining, TUNEL staining, and immunohistochemical staining were employed to verify the modelling status and damage mechanism. Research findings show that, compared to the control group, rabbits exposed to 18Gy and 20Gy radiation doses exhibited significant bone necrosis after tooth extraction. Key observations included extensive bone tissue necrosis, increased osteoclasts (P < .05), reduced vascularization (P < .001), exacerbated fibrosis (P < .001), decreased bone density, disrupted trabecular structure, and damaged bone surface microstructure. In contrast, the 16Gy group showed some bone damage but did not meet bone necrosis criteria. This study established an animal model appropriate for inducing ORNJ with a single large dose of radiation. This work provides a solid experimental basis and a theoretical framework for further studies of ORNJ pathogenesis in particular to explore effective preventive and clinical treatment strategies.
Publicações recentes
Use of Nerve Tape for Sutureless Neurorrhaphy With Nerve Allograft in Repair of the Inferior Alveolar Nerve.
Management of Osteoradionecrosis in Jaws.
Hyperbaric Oxygen Effects on Surgical Outcomes in Mandibular Osteoradionecrosis Requiring Segmental Resection and Free Tissue Transfer.
What Is the Effectiveness of Tocopherol and Pentoxifylline in the Treatment of Osteoradionecrosis of the Mandible?
Establishment of an Osteoradionecrosis Model and its Mechanism Via Single Ionizing Radiation Exposure.
📚 EuropePMC126 artigos no totalmostrando 59
Use of Nerve Tape for Sutureless Neurorrhaphy With Nerve Allograft in Repair of the Inferior Alveolar Nerve.
The Journal of craniofacial surgeryManagement of Osteoradionecrosis in Jaws.
Seminars in plastic surgeryHyperbaric Oxygen Effects on Surgical Outcomes in Mandibular Osteoradionecrosis Requiring Segmental Resection and Free Tissue Transfer.
Facial plastic surgery & aesthetic medicineWhat Is the Effectiveness of Tocopherol and Pentoxifylline in the Treatment of Osteoradionecrosis of the Mandible?
The LaryngoscopeEstablishment of an Osteoradionecrosis Model and its Mechanism Via Single Ionizing Radiation Exposure.
International dental journalSecond paradigm shifts in the management of osteoradionecrosis of the mandible.
Oral oncologyLong-term follow-up of osteoradionecrosis of the mandible.
Acta odontologica ScandinavicaCarcinoma buccal mucosa treated with definitive hypofractionated accelerated radiotherapy: a retrospective analysis of treatment outcomes.
Singapore medical journal[A Case of Reconstruction of the Osteoradionecrosis of the Jaw Using the Patient-Specific Custom-Made Cutting Guide and Mandibular Reconstruction Plate].
Gan to kagaku ryoho. Cancer & chemotherapyOsteoradionecrosis After Mandibulotomy and Marginal Mandibulectomy in Patients With Oral Cancer.
CureusThree-dimensional (3D) anatomic location, extension, and timing of severe osteoradionecrosis of the mandible.
Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation OncologyThe role of hyperbaric oxygen therapy in the treatment of radiation lesions.
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of MexicoBilateral reconstruction of the mandibular body with symphyseal preservation using a single fibula free flap: operative technique.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialeA review on the classification of mandibulectomy defects and suggested criteria for a universal description.
The Journal of prosthetic dentistryThe 3D-printed miniplate-jig system: a new, rapid, precise, and user-friendly approach to miniplate fixation of free-tissue mandibular reconstructions.
The British journal of oral & maxillofacial surgeryA Combined Transoral and Contralateral Submandibular Approach in the Surgical Management of Osteoradionecrosis of the Mandible With Free Flap Reconstruction.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial SurgeonsLong term outcomes of Carcinoma Buccal Mucosa treated with High Dose Rate Interstitial Brachytherapy.
BrachytherapySpeech and Swallowing Outcomes Following Surgical Resection with Immediate Free Tissue Transfer Reconstruction for Advanced Osteoradionecrosis of the Mandible Following Radiation Treatment for Head and Neck Cancer.
DysphagiaNear-total mandibular reconstruction following osteoradionecrosis with double scapula tip free flap: A case report.
MicrosurgerySurgical Management of Bilateral Osteoradionecrosis of the Mandible.
The Journal of craniofacial surgeryNormal Tissue Complication Probability (NTCP) Prediction Model for Osteoradionecrosis of the Mandible in Patients With Head and Neck Cancer After Radiation Therapy: Large-Scale Observational Cohort.
International journal of radiation oncology, biology, physicsReconstruction of a pathologic fracture following osteomyelitis of the mandible using a fibula osteocutaneous flap.
Archives of craniofacial surgery[Influential factors related to osteoradionecrosis of the mandible in oral and maxillofacial cancer patients following radiotherapy].
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatologyThree salvage strategies in microvascular fibula osteocutaneous flap for mandible reconstruction with vascular compromise and establishment of an algorithm.
MicrosurgerySuccessful Hypoglossal Nerve Upper Airway Stimulator Implantation After Chemoradiotherapy for Oropharynx Malignancy Complicated by Mandibular Osteoradionecrosis.
Ear, nose, & throat journalFasciocutaneous Flaps for Refractory Intermediate Stage Osteoradionecrosis of the Mandible-Is It Time for a Shift in Management?
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial SurgeonsUse of CAD-CAM Bridging Mandibular Prosthesis in Osteonecrosis of the Jaw: The Experience of Our School.
Journal of clinical medicineMesenchymal Stem Cell Therapy for Osteoradionecrosis of the Mandible: a Systematic Review of Preclinical and Human Studies.
Stem cell reviews and reportsFalse vocal cord perforation with abscess treated by negative pressure wound therapy.
SAGE open medical case reportsOsteoradionecrosis of the mandible: Why not to be more aggressive in earlier stage?
American journal of otolaryngologyOsteoradionecrosis of the mandible after radiotherapy for head and neck cancer: risk factors and dose-volume correlations.
Acta oncologica (Stockholm, Sweden)Chinese expert group consensus on diagnosis and clinical management of osteoradionecrosis of the mandible.
International journal of oral and maxillofacial surgeryMandibular rescue: Application of the ALT fascia free flap to arrest osteoradionecrosis of the mandible.
American journal of otolaryngologyProtocol for prospective randomised assessor-blinded pilot study comparing hyperbaric oxygen therapy with PENtoxifylline+TOcopherol± CLOdronate for the management of early osteoradionecrosis of the mandible.
BMJ openThe irradiated human mandible: A quantitative study on bone vascularity.
Oral oncologyManagement of incidental discovery of microscopic squamous cell carcinoma in zones of osteoradionecrosis of the mandible.
European annals of otorhinolaryngology, head and neck diseasesNomogram model to predict postoperative relapse after mandibular osteoradionecrosis surgery.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial SurgeryComputer-assisted resection and reconstruction of bilateral osteoradionecrosis of the mandible using 2 separate flaps prepared from a single fibula.
Oral surgery, oral medicine, oral pathology and oral radiologyHOPON (Hyperbaric Oxygen for the Prevention of Osteoradionecrosis): a randomised controlled trial of hyperbaric oxygen to prevent osteoradionecrosis of the irradiated mandible: study protocol for a randomised controlled trial.
TrialsRare presentation of heterotopic ossification along a fibula free flap pedicle in a high-volume microvascular reconstruction practice.
Head & neckHyperbaric Oxygen Therapy for Wound Dehiscence After Intraoral Bone Grafting in the Nonirradiated Patient: A Case Series.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial SurgeonsNomogram model to predict postoperative infection after mandibular osteoradionecrosis surgery.
Scientific reportsOsteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy.
CancerThe histological and histomorphometric changes in the mandible after radiotherapy: An animal model.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial SurgeryThe efficacy of hyperbaric oxygen therapy related to the clinical stage of osteoradionecrosis of the mandible.
International journal of oral and maxillofacial surgeryFibular flap for mandible reconstruction in osteoradionecrosis of the jaw: selection criteria of fibula flap.
Maxillofacial plastic and reconstructive surgery[Mandibular osteoradionecrosis (ORN) as a side effect of head and neck cancer treatment: Factors that induce it].
Gaceta medica de MexicoComparison of the incidence of osteoradionecrosis with conventional radiotherapy and intensity-modulated radiotherapy.
Head & neckNew perspectives on the conservative management of osteoradionecrosis of the mandible: A literature review.
Head & neckAccuracy of virtually 3D planned resection templates in mandibular reconstruction.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial SurgeryDiagnostic Features and Management Strategy of a Refractory Case of Osteoradionecrosis of the Mandible: Case Report and Review of Literature.
Journal of maxillofacial and oral surgeryBuccinator Myomucosal Flap for Treatment of Osteoradionecrosis of the Mandible.
Clinical and experimental otorhinolaryngologyRole of Negative-Pressure Wound Therapy in the Management of Submandibular Fistula After Reconstruction for Osteoradionecrosis.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial SurgeonsOutcomes of microvascular free flap reconstruction for mandibular osteoradionecrosis: A systematic review.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial SurgeryLongitudinal evaluation of health-related quality of life after osteoradionecrosis of the mandible.
The British journal of oral & maxillofacial surgeryRisk profile for osteoradionecrosis of the mandible in the IMRT era.
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]Retrospective analysis of osteoradionecrosis of the mandible: proposing a novel clinical classification and staging system.
International journal of oral and maxillofacial surgeryOsteoradionecrosis of the mandible: A ten year single-center retrospective study.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial SurgerySynchronous reconstruction of bilateral osteoradionecrosis of the mandible using a single fibular osteocutaneous flap in patients with nasopharyngeal carcinoma.
Head & neckAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Use of Nerve Tape for Sutureless Neurorrhaphy With Nerve Allograft in Repair of the Inferior Alveolar Nerve.
- What Is the Effectiveness of Tocopherol and Pentoxifylline in the Treatment of Osteoradionecrosis of the Mandible?
- Management of Osteoradionecrosis in Jaws.
- Hyperbaric Oxygen Effects on Surgical Outcomes in Mandibular Osteoradionecrosis Requiring Segmental Resection and Free Tissue Transfer.
- Establishment of an Osteoradionecrosis Model and its Mechanism Via Single Ionizing Radiation Exposure.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:521127(Orphanet)
- MONDO:0033839(MONDO)
- GARD:22138(GARD (NIH))
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
