Abstract
Management of osteoradionecrosis (ORN) has not yet reached a consensus, so it remains complex and difficult to manage, with a poor prognosis. The objective was to report the treatment of ORN based on a protocol including antimicrobial photodynamic therapy (aPDT), irrigation with 0.12% chlorhexidine, surgical debridement, and application of 0.2% chlorhexidine gel. Fifteen patients were enrolled in this case series comprising 100% men; 66.6% were submitted to conformational radiotherapy, 86.6% underwent chemotherapy as part of the treatment, 86.6% were smokers, and 73.3% were alcohol addicts. The diagnosis was made both in clinical and imaging exams. Of the 15 cases, 73.3% had mucosal healing without pathological fracture, 13.3% had no wound healing and/or pathological fracture, and 6.6% had pathological mandible fracture without area healing. It was concluded that aPDT management associated with 2% chlorhexidine gel and 0.12% chlorhexidine solution plus surgical debridement was effective in 86.6% of ORN cases reaching no pathologic fracture and/or mucosal healing.
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