Journal
MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL
Volume 26, Issue 2, Pages E195-E207Publisher
MEDICINA ORAL S L
DOI: 10.4317/medoral.24132
Keywords
Osteoradionecrosis; radiotherapy bone necrosis; hyperbaric oxygen; pentoxifylline; teriparatide; low level laser therapy
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Based on a systematic review of the literature, early intervention with conservative surgical combined with pharmacological methods appears to improve the prognosis of ORN.
Background: to systematically review the literature, comparing the healing of osteoradionecrosis (ORN) among the therapeutic alternatives: surgical, pharmacological and combined. Material and Methods: The review was organized according to the PRISMA protocol with regards to the following PICO question: patients with ORN of the jaws (P=Patient); all interventions reported (I = intervention); between all therapies (C=Comparison); healing of lesions (O=outcome). Results: Surgical treatment was the most common choice (46.3%) followed by pharmacological treatment, exclusively (25.9%) or combined (26.9%). Treatment exclusively by surgical intervention seems to be most effective option, with 51.2% of the lesions healed, OR for healing of 5.7 (CI95% 1.9-16.9, p=0.002). Only 1 case (0.9%) corresponded to low level laser therapy. Conclusions: It seems clear that early intervention with conservative surgical combined with pharmacological methods improves the prognosis of ORN.
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