Osteoradionecrosis - Our Experience

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Osteoradionecrosis (ORN) is a condition of nonvital bone in a site of radiation injury. ORN can be spontaneous, but it most commonly results from tissue injury. The absence of reserve reparative capacity is a result of the prior radiation injury. Even apparently innocuous forms of trauma such as denture-related injury, ulcers, or tooth extraction can overwhelm the reparative capacity of the radiation-injured bone.
Ref: Osteoradionecrosis of the Mandible
Original Post
I have a dental problem in my mandible, requiring root canal or extraction of a molar. Current symptoms include swollen gum and a swollen lymph node (a surprise as I thought they had all been removed in surgery!) Hospital appointment on Monday - any particular questions I should be asking?
Hello 200

How did it go? Sorry, I missed your question. I am in Melbourne visiting my daughter. Here is my belated advice:

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Just make sure they are aware that you had radiotherapy and know which areas were and were not irradiated (as that determines if there is a risk of ORN if you have an extraction). If there is a risk, is the tooth suitable for having root canal treatment and if so, do they have someone experienced (a specialist) to do it or would you be better off having your dentist do this. (Your more experienced dentist (as they do more root canals in practice than in hospital) might feel happier having a letter from the department requesting him to do it.)


Hope that helps.

Best wishes
Vinod
Hospital thought root canal treatment would work and my tooth survive, so I've been referred back for that. I have my dental work done at the local dental school, very impressed with them as they take ages over everything and the supervising dentists clearly know their stuff.
Hospital have also referred me for an ultrasound on my swollen node, this is happening on Monday.
Hi suedebottom (nice name!)

As a head/neck cancer patient (RT etc) I am surprised you wasn't referred to Maxillofacial at your local hospital - do push for it.

Maxillo were brilliant - I had a real phobia of my local dentist attempting to do any work on extractions. (My fault - not the dentist)

There are no facilities for hyperbaric oxygen treatment anywhere local to me. I have heard of their efficacy.

good luck - tony k

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