Osteonecrosis of the Jaw: From Early Detection to Effective Treatment (On-Demand)-Webinar Recording

Video Transcription

Video Summary

Dr. Kim, a head and neck oncology and reconstructive surgeon at City of Hope, discussed osteonecrosis of the jaw caused by radiation or medications such as bisphosphonates and denosumab. Both conditions involve devitalized jawbone and can cause pain, infection, and major impacts on quality of life. Osteoradionecrosis is now understood as a progressive radiation-induced fibroatrophic process, while medication-related osteonecrosis is associated with suppressed bone remodeling and reduced blood supply.<br /><br />Risk factors include poor oral health, dental extractions or trauma, high radiation doses, and systemic conditions such as diabetes, smoking, steroid use, and malnutrition. Imaging—particularly panoramic X-rays and CT—is used to assess disease extent; biopsy helps rule out cancer recurrence.<br /><br />Management depends on severity. Early disease may be treated conservatively with oral hygiene, antiseptic rinses, and limited debridement. Advanced disease may require removal of necrotic bone and reconstruction with vascularized tissue. Hyperbaric oxygen has a debated role and is not a substitute for definitive surgery in severe cases. Prevention is essential: evaluate and treat dental disease before radiation or high-dose antiresorptive therapy, allowing time for healing whenever possible.

Keywords

osteonecrosis of the jaw

osteoradionecrosis

medication-related osteonecrosis

bisphosphonates

denosumab

radiation therapy

jawbone necrosis

dental prevention