Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review

Int Dent J. 2018 Feb;68(1):22-30. doi: 10.1111/idj.12318. Epub 2017 Jun 25.


Osteoradionecrosis (ORN) of the jaws is a pernicious complication of radiation therapy for head and neck tumours. This article aims to provide an update on data related to the definition, epidemiology, staging, and clinical and radiological findings of ORN of the jaws. Using certain keywords, an electronic search was conducted spanning the period from January 1922 to April 2014 to identify the available related investigations. Pooled data were then analysed. ORN is described as exposed irradiated bone that fails to heal over a period of 3 months without evidence of persisting or recurrent tumour. The prevalence of ORN varies in the literature. Several staging or scoring systems of ORN have been proposed. Clinical findings include ulceration or necrosis of the mucosa with exposure of necrotic bone. Radiological findings are not evident in the early stages of ORN. Furthermore ORN may not be apparent in imaging even when the disease is advanced. Taking into account the severity of ORN and the difficulties in diagnosing it early and accurately, the clinician should be aware of this complex entity in order to prevent its appearance or the development of more severe complications.

Keywords: Clinical findings; epidemiology; jaw; osteoradionecrosis; radiation therapy.

Publication types

  • Review

MeSH terms

  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Necrosis
  • Osteoradionecrosis / diagnostic imaging
  • Osteoradionecrosis / epidemiology
  • Osteoradionecrosis / etiology*
  • Osteoradionecrosis / pathology
  • Prevalence
  • Radiotherapy / adverse effects
  • Ulcer / pathology