Clinical study on osteoradionecrosis of the jaws.
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概要
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Radiotherapy is indispensable as one of the treatments for malignant tumor in maxillomandibular and oral surgical field and the best way for preservation of functions, but it causes osteoradionecrosis in some cases.<BR>The incidence of osteoradionecrosis in maxillomandibular and oral surgical field is higher than in other bone sites because the mandible is included in the irradiation field in addition to the presence of teeth and various anatomical factors.<BR>In the present study osteoradionecrosis which had developed after radiotherapy for malignant tumor was studied clinically and therapeutically and the following results were obtained.<BR>1. The subjects were 28 patients with squamous cell carcinoma and 2 patients with adonoid cystic carcinoma aged 38 to 72. The ratio of male: female was 3.3: 1. The time of manifestation was 1 month-14 years after irradiation. The main symptoms were pain and exposed bone mainly in the region of mandibular molar tooth.<BR>2. Osteoradionecrosis was observed in 10 cases supposed to be induced by tooth extraction but also in 5 edentulous cases.<BR>3. When the osteoradionecrosis cases were classified into limited area type and wide range type on the basis of clinical findings. X-ray of the jaws showed the presence of bone resorption and induration together in many wide range type cases.<BR>4. Scintigram of bone showed widespread accumulation of radiation even in clinically limited area type, and the picture of some loss of bone and the intensity of the accumulation were considered to be extremely useful as an index in making therapeutical plans and decisions on the prognosis of tumor of the jaws.<BR>5. As the method of treatment, sequestrectomy was performed in 14 of 19 cases of the limited area type and 4 of 11 cases of the wide range type and excision of the jaws in 4 cases.<BR>6. Hyperbaric oxygen therapy was carried out in 3 cases and had good effect.
- 社団法人 日本口腔外科学会の論文
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