Ostéoradionécroses des maxillaires (maxillaire et mandibulaire)

Osteoradionecrosis of the jaws is a well known complication of radiation therapy used in head and neck cancer. Osteoradionecrosis has been first described by Regaud in 1922. Osteoradionecrosis of the jaws is most of the time developed on mandibula; maxillary localisation is rare. Osteoradionecrosis of the jaws is a priority considering that patients have recovered of their primary disease. Treating osteoradionecrosis is difficult because of the patient's health status and the poor healing capacities of the irradiated tissues. In addition, the quality and amount of vascular bed are reduced for microvascular reconstruction. Osteoradionecrosis physiopathology is not totally understood. Conservative treatment is possible at the very beginning of the disease, but as much as the osteoradionecrosis is growing and is ancient, the treatment must be radical. Concerning osteoradionecrosis, the main problem is to be able to perform radical treatment without lasting too much time with conservative treatment. Mandibular reconstruction using osteo-cutaneous free flaps is actually the best solution for concerned patients. Since osteoradionecrosis is a major complication of numerous anti-cancer treatments, the best management is odontostomatologic prevention and radiotherapy technique.