Osteoradionecrosis of the Jaws: What Every Oral Physician Should Know

Vijayalakshmi Gachinamath

Abstract: Objective: Osteoradionecrosis (ORN) of the jaws is a severe late complication of radiotherapy in head and neck cancer patients. Despite advances in radiation delivery and preventive dental care, ORN continues to cause significant morbidity. This narrative review aims to summarize the current understanding of the epidemiology, pathogenesis, clinical features, diagnostic criteria, imaging characteristics, and management strategies for ORN. Study Design: A narrative review of the English-language literature was performed using published clinical studies, reviews, and classic articles related to osteoradionecrosis of the jaws. Results: ORN is characterized by devitalized irradiated bone that fails to heal in the absence of recurrent malignancy. The mandible is affected more frequently than the maxilla due to its limited vascularity. Pathogenesis is multifactorial and has evolved from infection-based concepts to contemporary hypoxic-hypocellular-hypovascular and radiation-induced fibroatrophic models. Diagnosis relies on clinical persistence of bone exposure, radiographic changes, and exclusion of tumor recurrence. Management ranges from conservative care and pharmacologic antifibrotic therapy to hyperbaric oxygen therapy and surgical resection in advanced disease. Conclusions: ORN remains a challenging clinical entity with no universally accepted gold-standard treatment. Emphasis should be placed on prevention, early diagnosis, and stage-appropriate multidisciplinary management to optimize outcomes.

Keywords: Osteoradionecrosis, Radiotherapy complications, Mandible, Hyperbaric oxygen therapy, Pentoxifylline, Tocopherol

How to Cite?: Vijayalakshmi Gachinamath, "Osteoradionecrosis of the Jaws: What Every Oral Physician Should Know", Volume 15 Issue 1, January 2026, International Journal of Science and Research (IJSR), Pages: 195-196, https://www.ijsr.net/getabstract.php?paperid=SR26102154127, DOI: https://dx.doi.org/10.21275/SR26102154127