[en] The classic sequence in the pathogenesis of osteoradionecrosis of the jaws has been accepted as radiation, trauma, and infection. This paper challenges this sequence and offers a new one more accurately describing the biochemical and cellular pathology. The clinical data are based on 26 consecutive cases of osteoradionecrosis from which 12 en bloc resection specimens were cultured and stained for microorganisms. Review of the histories and treatments, as well as the microbial assays, indicates that microorganisms play only a contaminant role in osteoradionecrosis and that trauma is only one mechanism of tissue breakdown leading to the condition. The sequence suggested by this study is as follows: (1) radiation, (2) hypoxic-hypocellular-hypovascular tissue, (3) tissue breakdown, and (4) chronic non-healing wound

[en] Osteoradionecrosis is one of the most serious complication after heavy irradiation of bone and most particularly following treatment of cancers within the head and neck. The irradiated bone has the decreased vascularity and is easily infected. As a result, the spread of infection may cause a nonhealing wound that is very difficult to be treated. A comprehensive prophylactic dental care as well as proper blocking of the radiation field before radiotherapy must be considered to reduce the risk of osteoradionecrosis. We present three cases of osteoradionecrosis which developed after extraction of teeth in irradiated patients

[en] Delayed sinonasal complications of radiation therapy include choanal stenosis, osteoradionecrosis, chronic sinusitis, and intranasal synechiae. Only sporadic cases on their surgical treatment have been reported, with equivocal results.

[en] Only 22 cases of osteoradionecrosis (ORN) of the jaws so severe as to require resection have been reported in 2,853 cases of head and neck tumours receiving radiation in doses capable of causing ORN between 1.1.1970 and 31.12.1981. But for surgical interference, including dental extractions both pre- and post-therapy, the incidence would have been even lower. The management of the irradiated patient and established necrosis is discussed. (author)

No abstract available

[en] The patient, 19 year old male, visited with complaints of trismus and consults for construction of denture. 4 years ago, he received 60Co teletherapy of left laryngeal area for treatment of throat tumor. Clinical appearance showed rampant dental caries, multiple root rest, xerostomia, disturbance of mandibular growth and asymmetry of face. Roentgenographic examination disclosed deep cervical caries, destruction of al veolar crest, and punched out bone destruction of mandible and maxilla.

No abstract available

[en] Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design

[en] Standardized panoramic radiograms were obtained from 2,160 dental outpatients, attending for the treatment at the department of Oral Radiology, Seoul National University Hospital in 1983. The results of this study about idiopathic osteosclerosis and condensing osteitis related to the periapical lesions are: 1. The incidence of idiopathic osteosclerosis was 16.0%, and the distribution of individuals affected by the idiopathic osteosclerosis was not significantly different between males and females. 2. Idiopathic osteosclerosis occurred most commonly in the mandible, and the premolar-molar region showed high occurrences (82.1%). 3. The incidence of condensing osteitis was 9.8%, and the distribution of individuals affected by condensing osteitis was not significantly different between males and females.

No abstract available