New perspectives on the conservative management of osteoradionecrosis of the mandible: A literature review

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• 作者：Diogo Alpuim Costa ; Tiago Porfí ; rio Costa ; Eduardo Carlinhos Netto ; Naté ; rcia Joaquim ; Isabel Ventura ; Ana Cristina Pratas ; Patrí ; cia Winckler ; Inê ; s Pires Silva ; Ana Catarina Pinho ; Isabel Goulã ; o Sargento ; Francisco Gamito Guerreiro and Antó ; nio Rita Moreira
• 刊名：Head & Neck
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：38
• 期：11
• 页码：1708-1716
• 全文大小：448K
• ISSN：1097-0347

文摘

Over the last decades, several therapeutic options were considered in the treatment of the osteoradionecrosis (ORN) of the mandible, including supportive measures, ultrasound therapy, corticosteroids, hyperbaric oxygen, surgical resection with reconstruction, and, more recently, drugs capable of reversing the fibroatrophic process. Once established, the ORN does not spontaneously disappear and a standard treatment has not yet been defined. The clear clinical effectiveness of hyperbaric oxygen therapy (HBOT) varies according to the literature and there are some economic/logistic issues to be considered; the triplet tocopherol/pentoxifylline/clodronate demands greater evidence from randomized clinical trials and also resilience from the patient, given the long treatment duration and its possible side effects. Controversy around the ideal treatment of the initial stage ORN of the mandible persists. More rigorous randomized prospective trials are essential. The purpose of this article was to review the relevant literature on the physiopathology of ORN of the mandible and discuss the new perspectives of its conservative treatment.