Osteoradionecrosis-A review of current concepts in defining the extent of the disease and a new classification proposal

Andrew Lyons*, Jona Osher, Elinor Warner, Ravi Kumar, Peter A. Brennan

*Corresponding author for this work

    Research output: Contribution to journalLiterature reviewpeer-review

    73 Citations (Scopus)


    Osteoradionecrosis (ORN) is potentially a debilitating and serious consequence of radiotherapy to the head and neck. Although it is often defined as an area of exposed bone that does not heal, it can also exist without breaching the mucosa or the skin. Currently, 3 classifications of ORN are in use, but they depend on the use of hyperbaric oxygen or are too complicated to be used as a simple aide-memoire, and include features that do not necessarily influence its clinical management. We propose a new classification to cover these shortcomings and to take into account the increasingly widespread use of antifibrotic medical treatment. We classified a series of 85 patients with varying seventies of ORN into 4 groups. An analysis of the outcomes of the series showed that the classification staged the severity of the condition simply and that the stage was relevant to both treatment and outcome. The new classification was therefore verified by the series presented. (C) 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

    Original languageEnglish
    Pages (from-to)392-395
    Number of pages4
    JournalBritish Journal of Oral and Maxillofacial Surgery
    Issue number5
    Publication statusPublished - May 2014


    • Osteoradionecrosis
    • Classification
    • Mandible
    • Maxilla
    • Head and neck cancer
    • Radiotherapy


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