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Article: Volume 49 Number 1 Page 64 - January 2022

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  Dental Update 496: 64-67

Oral surgery:  Osteoradionecrosis in the Current Era of Radiation Treatment

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Abstract: Osteoradionecrosis (ORN) is a late complication of radiotherapy treatment for head and neck cancer. In the past two decades there have been significant changes in the mode by which radiation is delivered and it was assumed this would lead to a reduction, or even elimination, of this complication. Paradoxically, ORN rates may have risen. This article provides a summary of the current understanding and approach to ORN.

Clinical relevance: Those who have had radiotherapy carry a life-long risk of developing osteoradionecrosis, and it is important that the dental team are aware of this.

Author notes: Vinod Patel, BDS (Hons), MOralSurg RCS Eng, FDSRCS, PhD, Consultant (Oral Surgery), Oral Surgery Department, Guy’s Dental Hospital, London. Michael Fenlon, MA, PhD, BDentSc, FDS, Professor of Prosthodontics/Honorary Consultant (Restorative Dentistry), Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London. Lucy Di Silvio, PhD, Professor of Tissue Engineering. Centre for Clinical, Oral and Translational Science, King’s College London. Mark McGurk, MD, FRCS, DLO, FDS, RCS, Professor/Consultant (Oral and Maxillofacial Surgeon), Head and Neck Centre, Division of Surgical Interventional Sciences, University College London. email:

Objective: To highlight the current philosophy regarding the aetiology of osteoradionecrosis and its relationship to current radiation delivery systems.