--- abstract: 'Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Pretreatment dental assessment should be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally and, as a result, they succumb to complicated oral adverse effects after radiation therapy. Osteoradionecrosis (ORN) is a severe debilitating condition that impairs healing due to reduction in vascularity and osteocyte population in the affected bone. This article reviews methods of treatment used to treat ORN such as antibiotics, hyperbaric oxygen therapy, therapeutic ultrasound, surgery, and other modalities. {\^A}{\copyright} 2006 Elsevier. All rights reserved.' altloc: [] chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: - ~ - ngeowy@um.edu.my - ~ - ~ creators_name: - family: Ramli given: R. honourific: '' lineage: '' - family: Ngeow given: W.C. honourific: Dr. lineage: '' - family: Rahman given: R. A. honourific: '' lineage: '' - family: Chai given: W. L. honourific: '' lineage: '' date: 2006-12 date_type: published datestamp: 2012-04-25 13:04:28 department: ~ dir: disk0/00/00/81/54 edit_lock_since: ~ edit_lock_until: 0 edit_lock_user: ~ editors_id: [] editors_name: [] eprint_status: archive eprintid: 8154 fileinfo: application/pdf;http://cogprints.org/8154/1/Managing%20Complications%20Of%20Radiation%20Therapy%20In%20Head%20And%20Neck%20Cancer%20Patients%2DPart%20IV.%20Management%20Of%20Osteoradionecrosis.pdf full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: ~ item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: Head and neck cancer Hyperbaric oxygen Osteoradionecrosis Radiation therapy Ultrasound therapy bone necrosis head and neck tumor human jaw disease review risk factor Head and Neck Neoplasms Humans Hyperbaric Oxygenation Jaw Diseases Risk Factors Ultrasonic Therapy lastmod: 2012-04-25 13:04:28 latitude: ~ longitude: ~ metadata_visibility: show note: "Cited By (since 1996): 1 Export Date: 7 March 2012 Source: Scopus PubMed ID: 17378336 Language of Original Document: English Correspondence Address: Ngeow, W.C.; Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia; email: ngeowy@um.edu.my References: Regaud, C., Sur la necrose des os attients par un processus cancereux et traiters par les radiations (1922) Compt Rend Soc de Biol, 87, p. 629; Morrish, R.B., Osteoradionecrosis in patients irradiated for head and neck carcinoma (1981) Cancer, 47, pp. 1980-1983; Marx, R.E., A new concept in the treatment of osteoradionecrosis (1983) J Oral Maxillofac Surg, 41, pp. 351-357; Hutchinson, I.L., Complications of radiotherapy in the head and neck: An orofacial surgeon's view (1996) Current Radiation Oncology, pp. 144-177. , Tobias JS, Thomas PRM, eds, London: Arnold; Vudiniabola, S., Pirone, C., Williamson, Goss, A.N., Hyperbaric oxygen in the prevention of osteoradionecrosis of the jaws (1999) Aust Dent J, 44, pp. 243-247; Joyston-Bechal, S., Management of oral complications following radiotherapy (1992) Dent Update, 19, pp. 232-238; Marx, R.E., Osteoradionecrosis: A new concept of its pathophysiology (1983) J Oral Maxillofac Surg, 41, pp. 283-288; Kanatas, A.N., Rogers, S.N., Martin, M.V., A practical guide for patients undergoing exodontia following radiotherapy to the oral cavity (2002) Dent Update, 29, pp. 498-503; Rothwell, B.R., Prevention and treatment of orofacial complications of radiotherapy (1987) J Am Dent Assoc, 114, pp. 316-332; Devlin, H., Barker, G.R., Prosthetic and surgical care of the elderly radiotherapy patient: The GDP's role (1988) Dent Update, 15, pp. 168-169; Carl, W., Ikner, C., Dental extractions after radiation therapy in the head and neck area and hard tissue replacement (HTR) therapy: A preliminary study (1998) J Prosthet Dent, 79, pp. 317-322; Haber-Cohen, A., Debuski, S., Management of oral and maxillofacial surgery procedures in irradiated patients (1990) Dent Clin North Am, 34, pp. 71-77; Kanatas, A.N., Rogers, S.N., Martin, M.V., A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity (2002) Br Dent J, 192, pp. 157-160; Marx, R.E., Johnson, R.P., Kline, S.N., Prevention of osteoradionecrosis: A randomised prospective clinical trial of hyper-baric oxygen versus penicillin (1985) J Am Dent Assoc, 111, pp. 49-54; Mealey, B.L., Semba, S.E., Hallmon, W.W., The head and neck radiotherapy patient: Part 2. Management of oral complications (1994) Campend Contin Educ Dent, 15, pp. 442-456; Harris, M., The conservative management of osteoradionecrosis of the mandible with ultrasound therapy (1992) Br J Oral Maxillofac Surg, 30, pp. 313-318; Young, S.R., Dyson, M., The effect of therapeutic ultrasound on angiogenesis (1990) Ultrasound Med Biol, 16, pp. 261-269; Dyson, M., Franks, C., Suckling, J., Stimulation of healing of varicose ulcers by ultrasound (1976) Ultrasonics, 14, pp. 232-236; Heckman, J.D., Ryaby, J.P., McCabe, J., Frey, J.J., Kilcoyne, R.F., Acceleration of tibial fracture-healing by non-invasive, low intensity pulsed ultrasound (1994) J Bone Joint Surg Am, 76, pp. 26-34; Pilla, A.A., Mont, M.A., Nasser, P.R., Non-invasive low intensity pulse ultrasound accelerates bone healing in rabbit (1990) J Orthop Trauma, 4, pp. 246-253; Tsai, C.L., Chang, W.H., Liu, T.K., Preliminary studies of duration of intensity of ultrasonic treatments on fracture repair (1992) Chin J Physiol, 35, pp. 21-26; Wang, S.J., Lewallen, D.G., Bolander, M.E., Chao, E.Y., Ilstrup, D.M., Greenleaf, J.F., Low intensity ultrasound treatment increases strength in a rat femoral fracture model (1994) J Orthop Res, 12, pp. 40-47; Harvey, W., Dyson, M., Pond, J.B., Grahame, R., The stimulation of protein synthesis in human fibroblasts by therapeutic ultrasound (1975) Rheumatol Rehabil, 14, p. 237; Reher, P., Harris, M., Ultrasound for the treatment of osteoradionecrosis (1997) J Oral Maxillofac Surg, 55, pp. 1193-1194; Doan, N., Reher, P., Meghji, S., Harris, M., In vitro effects of therapeutic ultrasound on cell proliferation, protein synthesis, and cytokine production by human fibroblasts, osteoblasts, and monocytes (1999) J Oral Maxillofac Surg, 57, pp. 409-419; Marx, R.E., Mandibular reconstruction (1993) J Oral Maxillofac Surg, 51, pp. 466-479; Barak, S., Rosenblum, I., Czerniak, P., Treatment of osteoradionecrosis combined with pathologic fracture and osteomyelitis of the mandible with electromagnetic stimulation (1988) Int J Oral Maxillofac Surg, 17, pp. 253-256; Eppley, B.L., Connolly, D.T., Winkelmann, T., Sadove, A.M., Heuvelman, D., Feder, J., Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation (1991) Reconstr Surg, 88, pp. 1-11; Archibald, D., Shklar, G., The effect of calcitonin on experimental osteoradionecrosis in mice (1985) J Oral Med, 40, pp. 7-12; King, G.E., Scheetz, J., Jacob, R., Martin, J.W., Electrotherapy and hyperbaric oxygen: Promising treatments for postradiation complications (1989) J Prosthet Dent, 62, pp. 331-334" number: 1 pagerange: 11-15 pubdom: TRUE publication: Singapore Dental Journal publisher: ~ refereed: TRUE referencetext: "Regaud, C., Sur la necrose des os attients par un processus cancereux et traiters par les radiations (1922) Compt Rend Soc de Biol, 87, p. 629; Morrish, R.B., Osteoradionecrosis in patients irradiated for head and neck carcinoma (1981) Cancer, 47, pp. 1980-1983; Marx, R.E., A new concept in the treatment of osteoradionecrosis (1983) J Oral Maxillofac Surg, 41, pp. 351-357; Hutchinson, I.L., Complications of radiotherapy in the head and neck: An orofacial surgeon's view (1996) Current Radiation Oncology, pp. 144-177. , Tobias JS, Thomas PRM, eds, London: Arnold; Vudiniabola, S., Pirone, C., Williamson, Goss, A.N., Hyperbaric oxygen in the prevention of osteoradionecrosis of the jaws (1999) Aust Dent J, 44, pp. 243-247; Joyston-Bechal, S., Management of oral complications following radiotherapy (1992) Dent Update, 19, pp. 232-238; Marx, R.E., Osteoradionecrosis: A new concept of its pathophysiology (1983) J Oral Maxillofac Surg, 41, pp. 283-288; Kanatas, A.N., Rogers, S.N., Martin, M.V., A practical guide for patients undergoing exodontia following radiotherapy to the oral cavity (2002) Dent Update, 29, pp. 498-503; Rothwell, B.R., Prevention and treatment of orofacial complications of radiotherapy (1987) J Am Dent Assoc, 114, pp. 316-332; Devlin, H., Barker, G.R., Prosthetic and surgical care of the elderly radiotherapy patient: The GDP's role (1988) Dent Update, 15, pp. 168-169; Carl, W., Ikner, C., Dental extractions after radiation therapy in the head and neck area and hard tissue replacement (HTR) therapy: A preliminary study (1998) J Prosthet Dent, 79, pp. 317-322; Haber-Cohen, A., Debuski, S., Management of oral and maxillofacial surgery procedures in irradiated patients (1990) Dent Clin North Am, 34, pp. 71-77; Kanatas, A.N., Rogers, S.N., Martin, M.V., A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity (2002) Br Dent J, 192, pp. 157-160; Marx, R.E., Johnson, R.P., Kline, S.N., Prevention of osteoradionecrosis: A randomised prospective clinical trial of hyper-baric oxygen versus penicillin (1985) J Am Dent Assoc, 111, pp. 49-54; Mealey, B.L., Semba, S.E., Hallmon, W.W., The head and neck radiotherapy patient: Part 2. Management of oral complications (1994) Campend Contin Educ Dent, 15, pp. 442-456; Harris, M., The conservative management of osteoradionecrosis of the mandible with ultrasound therapy (1992) Br J Oral Maxillofac Surg, 30, pp. 313-318; Young, S.R., Dyson, M., The effect of therapeutic ultrasound on angiogenesis (1990) Ultrasound Med Biol, 16, pp. 261-269; Dyson, M., Franks, C., Suckling, J., Stimulation of healing of varicose ulcers by ultrasound (1976) Ultrasonics, 14, pp. 232-236; Heckman, J.D., Ryaby, J.P., McCabe, J., Frey, J.J., Kilcoyne, R.F., Acceleration of tibial fracture-healing by non-invasive, low intensity pulsed ultrasound (1994) J Bone Joint Surg Am, 76, pp. 26-34; Pilla, A.A., Mont, M.A., Nasser, P.R., Non-invasive low intensity pulse ultrasound accelerates bone healing in rabbit (1990) J Orthop Trauma, 4, pp. 246-253; Tsai, C.L., Chang, W.H., Liu, T.K., Preliminary studies of duration of intensity of ultrasonic treatments on fracture repair (1992) Chin J Physiol, 35, pp. 21-26; Wang, S.J., Lewallen, D.G., Bolander, M.E., Chao, E.Y., Ilstrup, D.M., Greenleaf, J.F., Low intensity ultrasound treatment increases strength in a rat femoral fracture model (1994) J Orthop Res, 12, pp. 40-47; Harvey, W., Dyson, M., Pond, J.B., Grahame, R., The stimulation of protein synthesis in human fibroblasts by therapeutic ultrasound (1975) Rheumatol Rehabil, 14, p. 237; Reher, P., Harris, M., Ultrasound for the treatment of osteoradionecrosis (1997) J Oral Maxillofac Surg, 55, pp. 1193-1194; Doan, N., Reher, P., Meghji, S., Harris, M., In vitro effects of therapeutic ultrasound on cell proliferation, protein synthesis, and cytokine production by human fibroblasts, osteoblasts, and monocytes (1999) J Oral Maxillofac Surg, 57, pp. 409-419; Marx, R.E., Mandibular reconstruction (1993) J Oral Maxillofac Surg, 51, pp. 466-479; Barak, S., Rosenblum, I., Czerniak, P., Treatment of osteoradionecrosis combined with pathologic fracture and osteomyelitis of the mandible with electromagnetic stimulation (1988) Int J Oral Maxillofac Surg, 17, pp. 253-256; Eppley, B.L., Connolly, D.T., Winkelmann, T., Sadove, A.M., Heuvelman, D., Feder, J., Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation (1991) Reconstr Surg, 88, pp. 1-11; Archibald, D., Shklar, G., The effect of calcitonin on experimental osteoradionecrosis in mice (1985) J Oral Med, 40, pp. 7-12; King, G.E., Scheetz, J., Jacob, R., Martin, J.W., Electrotherapy and hyperbaric oxygen: Promising treatments for postradiation complications (1989) J Prosthet Dent, 62, pp. 331-334" relation_type: [] relation_uri: [] reportno: ~ rev_number: 8 series: ~ source: ~ status_changed: 2012-04-25 13:04:28 subjects: - JOURNALS - OJHAS succeeds: ~ suggestions: "Associate Prof. Dr. Ngeow Wei Cheong @ David Ngeow\r\nDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of\r\nMalaya, 50603 Kuala Lumpur, MALAYSIA\r\n\r\nAssociate Professor Dr. Ngeow Wei Cheong is currently a lecturer at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry of the University of Malaya. He graduated from the University of Malaya in 1992 and was a private practitioner for 9 months before he was offered the post of tutorship at his alma matter. Three years later, he went to do a house job at the Queen Victoria Hospital in East Grinstead, England. He obtained his Fellowship in Dental Surgery from the Royal College of Surgeons in Ireland and the Royal College of Surgeons ofEngland in 1996. He subsequently returned to Malaysia and was a pioneer lecturer at the then newly established Universiti Kebangsaan Malaysia. He left for private practice in 1999 but the temptation to return to academic life was greater, hence he returned to the University of Malaya the subsequent year. His research interest are craniofacial anthropometry, variations of the mandibular nerve, and recovery of peripheral nerves after microsurgical repair. \r\n \r\n\r\nAREAS OF EXPERTISE\r\n\t\r\nDentofacial Anthropometry (Head & Neck, anthropology)\r\n\r\nDental Analgesics (analgesic, local anaesthetic, COX-2 inhibitors)\r\n\r\nSurgical Anatomy (mental foramen, anterior loop)" sword_depositor: ~ sword_slug: ~ thesistype: ~ title: 'Managing complications of radiation therapy in head and neck cancer patients: Part IV. Management of osteoradionecrosis' type: journalp userid: 16514 volume: 28