Yayun Siti Rochmah


Background: Osteoradionecrosis (ORN) post dental extraction is post dental
extraction complication with post radiation cancer theraphy. Objective : to present rare case, ORN post dental extraction with post radiation Ca nasopharing therapy 3 years ago.
Case Management: A 54 years old patient reported to the dental out-patient department with a chief complaint of pus discharge from right buccal since post dental extraction 6 months ago. He gave a history of a nasopharing Carcinoma with histopatology as squamous cell carcinoms 3 years ago and radio therapy but no surgery. Intraoral examination, exposed necrotic bone found from right lower retromolar area 46 with pus discharge. Radiographic view was likely squester. Local surgical debridement and the sequestrectomy was undertaken with general anaesthesia. Antibiotic injection treatment was ceftriaxon 2x 1gram, infus metronidazol 3x500 mg and ketorolac 3x1 ampul, the patient was treated for 3 days and educated to maintain his oral hygiene with povidone iodine gargle.
Discussion: Osteoradionecrosis (ORN) is late effect of radiation therapy that
results in irreversible tissue death, which is clinically observed as bony exposure for more than 3 months duration. The mandible is affected more often than the maxilla or any other bones of head and neck region. The incidence of ORN in the mandible is reported to be between 2% and 22% and most often affects the body of the mandible. Ideal time is one year minimal post radiotherapy to get maximal vascularization for optimal healing. But immunity factor and radiation doses can trigger emergense ORN.
Conclusion: Need time consideration, clinic analysis and pathologys before doing dental extraction for post radiotherapy cancer cases to prevent ORN.


Osteoradionekrosis; Radiotheraphy; Dental extraction

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Siwi Setya Utami, Mustikasari, aspek psikososial pada penderita kanker payudara: studi pendahuluan, Jurnal Keperawatan Indonesia, Volume 20 No.2, Juli 2017, hal 65-74

Douglas E. Peterson & Wolfgang Doerr & Allan Hovan & Andres Pinto & Debbie Saunders & Linda S. Elting & Fred K. L. Spijkervet & Michael T. Brennan, Osteoradionecrosis in cancer patients: the evidence base for treatment-dependent frequency, current management strategies, and future studies, Support Care Cancer (2010) 18:1089–1098

Martin José C.,Hilgenberg A., Santos Frederico K., Management of Patients with Osteoradionecrosis of the after Radiation Therapy to the Head and Neck, Intl. Arch. Otorhinolaryngol., São Paulo, v.12, n.2, p. 239-245, 2008.

L. Alhilali, A.R. Reynolds, and S. Fakhran, Osteoradionecrosis after Radiation Therapy for Head and Neck Cancer:Differentiation from Recurrent Disease with CT and PET/CTImaging, AJNR Am J Neuroradiol 35:1405–11 Jul 2014

Nak Kym S and Bo Yeon K., Psychological stress and cancer, Journal of Analytical Science and Technology, Springers (2015), 6:30.

Jan-Dirk Raguse,Jaber Hossamo, Ingeborg Tinhofer, Bodo Hoffmeister, Volker Budach, et al, Patient and treatment-related risk factors for osteoradionecrosis of the jaw in patients with head and neck cancer, Oral Surgery Oral medicine Oral Pathology Oral Oral Radiology Journal March 2016 Volume 121, Issue 3, Pages 215–221.

Saleh A. Al-Bazie, Mesaad Bahatheq1, Mohamad Al-Ghazi1, Nasser Al-Rajhi1, Sundar Ramalingam, Antibiotic protocol for the prevention of osteoradionecrosis following dental extractions in irradiated head and neck cancer patients: A 10 years prospective study, Journal of Cancer Research and Therapeutics - April-June 2016 - Volume 12 - Issue 2.

Ravindran Rathy, S. Sunil, and M. Nivia, Osteoradionecrosis of mandible: Case report with review of literature, Contemp Clin Dent. 2013 AprJun; 4(2): 251–253.

Sultan A., Hanna G., Danielle NM, Chau N.,Goguen,Marty B., Guilherme R., Jonathan d. schoenfeld, et al., The Use of Hyperbaric Oxygen for the Prevention and Management of Osteoradionecrosis of the Jaw: A Dana-Farber/Brigham and Women’s Cancer Center Multidisciplinary Guideline, TheOncologist 2017;22:343–350.

DOI: http://dx.doi.org/10.30659/odj.6.1.19-22


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