Osteoradionecrosis of the mandible: A ten year single-center retrospective study.
BACKGROUND
Numerous factors have been associated with the development of osteoradionecrosis (ORN) of the jaws. The purpose of this study was to investigate the factors that are linked to the severity of mandibular ORN.


METHODS
A retrospective study was conducted which included all ORN cases treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU) between 2003 and 2012. The cases were categorized according to the necrosis stage and several variables were evaluated in order to identify possible correlation between them and the severity of the necrosis.


RESULTS
A total of 115 patients with 153 osteonecrosis lesions were included in the study. Twenty-three cases were of stage I, 31 were of stage II and 99 were of stage III. The initial tumors were predominantly located in the floor of the mouth, the tongue or the pharynx. Diabetes mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive alcohol consumption (OR: 5.428, 95% Cl: 1.622-18.171) and dental treatment and/or local pathological conditions (OR: 0.237, 95% Cl: 0.086-0.655) were significant predictors for stage III necrosis.


CONCLUSIONS
The aforementioned factors are predictive of ORN severity and can guide its prophylaxis and management.
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Lindwurmstraße 2a, Munich, 80337, Germany. Electronic address: arisx8@hotmail.com.
Aristeidis
A
Chronopoulos
Department of Endodontology, Dental School, Aristotle University of Thessaloniki, AUTH Campus, Thessaloniki, PC 54124, Greece. Electronic address: theozarra@gmail.com.
Theodora
T
Zarra
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Lindwurmstraße 2a, Munich, 80337, Germany. Electronic address: matthias.troeltzsch@med.lmu.de.
Matthias
M
Tröltzsch
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Lindwurmstraße 2a, Munich, 80337, Germany. Electronic address: salah.mahaini@med.lmu.de.
Salah
S
Mahaini
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Lindwurmstraße 2a, Munich, 80337, Germany. Electronic address: michael.ehrenfeld@med.uni-muenchen.de.
Michael
M
Ehrenfeld
Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Lindwurmstraße 2a, Munich, 80337, Germany. Electronic address: sven.otto@med.lmu.de.
Sven
S
Otto
D000368:Aged; D000428:Alcohol Drinking; D017024:Chemotherapy, Adjuvant; D003729:Dental Care; D048909:Diabetes Complications; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000145:classification* / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000532:radiotherapy; D009367:Neoplasm Staging; D010025:Osteoradionecrosis / Q000145:classification* / Q000209:etiology / Q000601:surgery; D010510:Periodontal Diseases / Q000150:complications; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D014062:Tongue Neoplasms / Q000532:radiotherapy
Mandible; Osteoradionecrosis; Radiation therapy; Risk factors; Severity