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Abstract
Objectives. The objective of this study was to assess the long-term progress of 26 patients who
experienced postradiation osteonecrosis of the jaw between 1975 and 1989.
Study design. Of 26 patients who had been previously managed with hyperbaric oxygen therapy as
a part of their treatment for postradiation osteonecrosis of the jaw, 20 were evaluated
to determine their current status of the condition: resolved, chronic persisting (unresolved),
or active progressive (symptomatic).
Results. Two of 20 patients experienced recurrences of the condition. In one of these patients,
surgical treatment was identified as the stimulus of postradiation osteonecrosis.
In the other patient, the recurrence appeared to be related to periodontal disease
activity. In 60% (12 of 20) of the patients, the condition remained resolved, improvement
in clinical staging occurred in 10% (2 of 20) (from symptomatic to unresolved or resolved),
and 20% (5 of 20) of the patients continued to demonstrate chronic persisting postradiation
osteonecrosis at the end of the long-term follow-up period.
Conclusion. This study supports the contention that postradiation osteonecrosis can occur at
any time after radiation therapy, and that patients remain at risk up to 231 months
after treatment of the cancer and probably indefinitely after radiation therapy. Our
findings also suggest that risk of second episodes of the condition after management
of an initial episode is low. In addition, our follow-up study revealed that chronic
nonprogressive postradiation osteonecrosis can remain stable without extensive intervention
including combined hyperbaric oxygen therapy and surgery.
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Article info
Publication history
Accepted:
January 27,
1997
Received in revised form:
August 12,
1996
Received:
June 18,
1996
Identification
Copyright
© 1997 Published by Elsevier Inc.
