The development of osteoradionecrosis from sites of periodontal disease activity: report of 3 cases.

Osteoradionecrosis may develop following radiation therapy that involves bone, and most particularly following treatment of cancers within the head and neck. The mandible is at greatest risk of osteoradionecrosis because of the nature of its blood supply and its dense bone configuration. This paper describes 3 cases which demonstrate the development of osteoradionecrosis in the mandible from sites of periodontal disease activity following external beam radiotherapy. The pathogenesis of these events is reviewed, and recommendations for their management are discussed. A proposal for the use of chlorhexidine digluconate and hyperbaric oxygen in the periodontal management of this condition is outlined.