Jaw necrosis associated with cancer treatment: a narrative literature review
DOI:
https://doi.org/10.5335/rfo.v31i1.18328Keywords:
Osteoradionecrosis, Head and neck neoplasms, Bisphosphonate-associated osteonecrosis, Differential diagnosisAbstract
Objective: To discuss differential clinical, imaging, and management aspects of drug-related osteonecrosis of the jaw (DRONJ) and osteoradionecrosis of the jaw (ORJ). Literature review: Bone necrosis is a condition characterized by the death of bone tissue due to interruption of local blood supply and can be induced by trauma, radiation, medication use, and infection. In response to antineoplastic treatment, bone necrosis can develop in the jaws as a serious complication: drug-related osteonecrosis of the jaw (DRONJ) and osteoradionecrosis of the jaw (ORJ). The two conditions studied have distinct etiological factors, although they share similar clinical manifestations. ORJ has a higher incidence in the mandible and is associated with a higher risk of pathological fractures. Radiographically, ORJ tends to manifest in irradiated areas, with diffuse margins and generally without evident periosteal reaction, while DRONJ may have more well-defined limits and subperiosteal bone apposition. ONMRM generally responds better to conservative treatment compared to ORNM, which often requires extensive surgical resections. Final considerations: ONMRM and ORNM represent serious complications arising from cancer treatment, and diagnosing them correctly is essential for effective preventive and curative management.
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