CONSERVATIVE TREATMENT OF MANDIBULAR OSTEORADIONECROSIS: EQUITY AND RATIONALIZATION OF RESOURCES - CASE REPORTS

Abstract

Introduction: Osteoradionecrosis (ORN) is one of the late adverse effects of radiotherapy whose classical treatments include hyperbaric therapy or surgical resection. Objective: To report the results obtained in the conservative treatment and control of mandibular ORN. Material and Methods: Six cases of ORN were treated with daily aqueous solution of chlorhexidine gluconate 0.12% mouthwash, rigorous oral hygiene and removal of irritants to the mucosa. The oral lesions of ORN had up to 2 cm in greatest diameter. Clinical follow-up was conducted weekly until early response to treatment and monthly, after that period. Response to therapy was classified as: total and partial remission, increased injury and absence of response. Results: Two of the six patients were female and four were male. Ages ranged from 39 to 78 years old. All cases showed some positive response to the treatment, three patients had partial remission and three patients had complete remission. In a week and a half, all patients presented total remission of ORN prodromal signs (pain and purulent secretion). The average time of treatment was 16.6 months. Conclusion: Reduction or total heal of all ORN cases were achieved. It was noticeable that these results avoided indication of both hyperbaric oxygen therapy and surgical resection. Thus, the treatment reported resulted in less morbidity to patients and rationalization of resources for the Public Health System. DESCRIPTORS: Oral Cancer. Radiotherapy. Osteoradionecrosis. Odontology. Chlorhexidine. Prevention. Public Health.