CASE REPORTS   

Minerva Stomatologica 2008 January-February;57(1-2):65-9

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Successful conservative treatment of osteoradionecrosis of the mandible associated with pathological fracture

Jham B. C. ¹, Aguiar M. C. ², Jham A. C. ³, Duraes G. V. ⁴, Fernandes A. M. ^{2, 4}

¹ Department of Diagnostic Sciences and Pathology University of Maryland Dental School Baltimore, ML, USA 2 Department of Oral Medicine Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte, Brazil 3 International Student Program University of Colorado School of Dentistry Denver, USA 4 Department of Oral Pathology School of Dentistry Universidade Federal do Vales do Jequitinhonha e Mucuri Diamantina, Brazil

Treatment of patients with osteoradionecrosis (ORN) of the mandible associated with pathologic fractures usually consists of a continuity resection of the mandible, leading to severe impairment of the patient’s health and quality of life. Conservative treatment may be alternatively attempted; however, it is not usually employed. Here, we report a successful conservative treatment of ORN associated with pathologic fracture. A 48-year-old black man who had undergone radiotherapy for a squamous cell carcinoma in the tongue 6 years previously sought care complaining of facial swelling and draining episodes. Since the patient was fiercely resistant to any kind of hospital-based therapy, a conservative approach was proposed. Daily irrigations with 2% potassium iodate, followed by 3% oxygenated water, were performed by the patient at his house. In addition, local cleaning and debridement were weekly performed at our dental clinic. Systemic antibiotics were also administered. Throughout the therapy course, bone fragments were spontaneously exfoliated. Resolution of the ulcer and fracture was observed after 6 weeks of treatment. This report shows that ORN may be conservatively managed in specific situations, with good cosmetic and functional results.