CARVALHO, D. A.; http://lattes.cnpq.br/1244881373157732; CARVALHO, Denildo de Araújo.
Resumo:
Radiation therapy (RT) is an effective and widely used treatment for malignant head
and neck neoplasms, however, this local irradiation brings with it some
consequences or injuries and among them, osteoarthionecrosis (ORN) is one of the
most serious. This manifests as an area of exposed necrotic bone in the jaw or jaw
that does not heal for at least three months. In most cases, osteoarthionecrosis
progresses gradually, becoming more extensive and painful, and its late
manifestations include infection and pathological fracture. This serious complication
appears late to the radiotherapy treatment and is usually associated with invasive
procedures, like dental extractions. In the last decades, several therapeutic options
have been considered in the treatment of maxillary ORN, including supportive
measures, hyperbaric oxygen, prophylactic use of pentoxifylline and tocopherol or
pentacolol, surgical resection with reconstruction and, more recently, drugs capable
of reversing the fibroatrophic process. The search for articles for this review, which
aimed to emphasize important aspects related to the preventive and therapeutic
management of osteorradionecrosis of maxillary bones, used the online search
bases: Scielo, Medline and Pubmed and as search strategies were used the
keywords: osteoradionecrosis, jaw, prevention and control and therapy, being limited
to the period from 1980 to 2018. Thus, this work emphasized the important role of the
dental surgeon in face of this pathological condition and concluded that the adequacy
of the buccal environment and oral surgeries before initiating RT can prevent the
onset of ORN. Therefore, prevention is the best practice and even with the existence
of several therapeutic options for the management of this condition, further studies
still need to be performed to substantiate these treatments.