Introduction: Radionecrosis of the jaw is a rare but serious complication in patients who undergo head and neck radiation therapy. The condition was first described by Regaud in 1922 with the term "osteoradionecrosis" (ORN). It is defined as "exposed non-vital irradiated bone that does not heal for more than three months and there is no evidence of a primary tumor, tumor recurrence, or metastases."
Aim: This review article aims to summarize the epidemiological data, etiopathogenesis, classification, staging systems, clinical findings, and diagnosis of ORN, as well as provide a critical analysis of the treatment and prevention methods.
Materials and Methods: An extensive search was performed in PubMed, Scopus, and Web of Science databases using the following keywords: ((osteoradionecrosis) OR (radionecrosis) OR (post-radiation necrosis) OR (post-radiation osteomyelitis)) AND (jaw). After analyzing the obtained data, 33 articles were included in this review.
Results and Discussion: The exact pathogenetic mechanisms for the development of ORN are not fully understood, but the etiology is assumed to be multifactorial. Treatment depends on the stage of ORN, typically involving a combination of conservative and surgical methods. Dentists play a key role in prevention through timely dental treatment and tooth extraction when indicated.
Conclusion: Osteoradionecrosis is a serious complication that can occur after head and neck radiotherapy. Its treatment requires a multidisciplinary approach. Efforts should aim for effective prevention and prophylaxis of the condition, optimization of conventional treatment protocols, and the adoption of new ones.
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