Camolesi GC, Ortega KL, Medina JB, Campos L, Lorenzo Pouso AI, Gándara Vila P, Pérez Sayáns M. Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review.
Med Oral Patol Oral Cir Bucal 2021;
26:e195-e207. [PMID:
33037800 PMCID:
PMC7980297 DOI:
10.4317/medoral.24132]
[Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/28/2020] [Indexed: 01/11/2023] Open
Abstract
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.
Key words:Osteoradionecrosis, radiotherapy bone necrosis, hyperbaric oxygen, pentoxifylline, teriparatide, low level laser therapy.
Collapse