การใช้ยาเพนทอกซิฟิลลินและโทโคเฟอรอลก่อนถอนฟันเพื่อป้องกันภาวะการเกิดกระดูกขากรรไกรตาย ในผู้ป่วยที่ได้รับรังสีรักษาบริเวณศีรษะและลำคอ: รายงานผู้ป่วย

Palida  Chamnanmoh

Authors

Palida Chamnanmoh Sawanpracharak Hospital

Keywords:

Osteoradionecrosis of jaw ORN, head and neck radiotherapy

Abstract

The objective of this case reports are to inform about the prevention guidelines of osteoradionecrosis after radiotherapy, including interventions in the oral cavity. Previously, prevention was primarily focused on high-pressure oxygen therapy after tooth extraction following radiation treatment. However, the theory proposed by Dalanian and colleagues in 2004 has gained prominence due to its alignment with various scientific studies. These studies cover topics such as the generation of free radicals from radiation, alterations in fibroblast cells in the extracellular matrix, and the occurrence of atherosclerosis in radiated areas, all of which are associated with osteoradionecrosis of the jaws. The case reports present patients who received pentoxifylline and tocopherol for prophylaxis against osteoradionecrosis of the jaws following multiple extractions based on this theory. Dental interventions involving bone and soft tissue manipulation are the primary causes of osteoradionecrosis, as indicated by many reviews. Osteoradionecrosis is a severe event associated with head and neck radiotherapy that can lead to mortality. The use of pentoxifylline and tocopherol is one prophylactic method with a lower incidence of osteoradionecrosis compared to many other new treatments. Although controversial due to low-quality reports, it remains a popular treatment due to its ease of use and cost-effectiveness. This report addresses various aspects associated with osteoradionecrosis of jaws.

Keywords: Osteoradionecrosis of jaw ORN, head and neck radiotherapy

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