Parameters Associated with Mandibular Osteoradionecrosis

William M. Mendenhall, Carlos Suárez, Eric M. Genden, Remco De Bree, Primož Strojan, Johannes A. Langendijk, Mäkitie M.A. Antti, Robert Smee, Avraham Eisbruch, Anne W.M. Lee, Alessandra Rinaldo, Alfio Ferlito

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The objective of this review is to discuss factors related to the risk of osteoradionecrosis (ORN) and how to minimize the likelihood of this complication. A PubMed search for publications pertaining to ORN within the last 3 years was conducted revealing 44 publications. The bibliographies of these publications were reviewed to identify additional references spanning a longer time period. The incidence of ORN is 5% to 10% with a median latency period of 1 to 2 years or less. The likelihood of ORN depends on a number of factors including primary site and extent of disease, dental status, treatment modality, radiotherapy (RT) dose, volume of mandible included in the planning target volume, RT fractionation schedule and technique, and teeth extractions. The risk of ORN may be reduced by limiting the RT dose and volume of mandible irradiated without increasing the risk of a local-regional recurrence due to a marginal miss.

Original languageEnglish
Pages (from-to)1276-1280
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Issue number12
StatePublished - 1 Dec 2018


  • head and neck cancer
  • mandible
  • mandibular osteoradionecrosis
  • radiotherapy
  • teeth extraction


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