Preventive and curative management of osteoradionecrosis in the oral sphere

Some cancers of the upper aerodigestive tract are treated with radiation therapy. One of the possible complications of this radiation therapy is osteoradionecrosis. The physiopathological mechanisms and treatments thereof are disputed. Material and methods: A review of the literature was carried out in order to highlight the means of prevention and current management of osteoradionecrosis. Result: Prevention significantly reduced the occurrence of osteoradionecrosis following radiotherapy. Many treatment methods have been implemented over the past thirty years. Currently, the gold standard treatment, once it has been diagnosed, is the combination of the PENTOCLO protocol with curative surgery. Discussion: The real efficacy of PENTOCLO has not been demonstrated despite excellent healing results. More randomized studies with larger study groups are needed. (author)