Studies in the radiobiology of osteoradionecrosis and their clinical significance.
The radiobiology of osteoradionecrosis is a complex of cellular death and cellular functional impairments from radiation energy transfers. Four studies of irradiated patients and a data base from 536 patients with osteoradionecrosis revealed separate pathophysiologic conditions for osteoradionecrosis induced by early trauma, osteoradionecrosis induced by late trauma, and spontaneous osteoradionecrosis. A large body of data suggested useful clinical guidelines for the management of irradiated patients. The guidelines, in part, include a recommendation for deferring radiation treatment for 21 days after tissue wounding, if possible; a relative contraindication to wounding tissue during a radiation course; a recommendation for the use of hyperbaric oxygen before wounding; and a strong recommendation to provide comprehensive dental care to the irradiated patient.
D055592:Biophysical Phenomena; D001703:Biophysics; D001808:Blood Vessels / Q000528:radiation effects; D001842:Bone and Bones / Q000528:radiation effects; D005355:Fibrosis; D006801:Humans; D006931:Hyperbaric Oxygenation; D008336:Mandibular Diseases / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D010025:Osteoradionecrosis / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D010101:Oxygen Consumption; D011832:Radiation Injuries / Q000473:pathology*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D014945:Wound Healing / Q000528:radiation effects