The relationship between dental disease and radiation necrosis of the mandible.

Preirradiation panoramic radiographs of forty-six dentate patients were examined for the presence of significant dental disease. The occurrence of necrosis of the mandible after these patients received radiation therapy was then determined. Evidence of a positive association between dental disease present before radiation therapy and subsequent necrosis of the mandible was found (p = 0.09), leading to a recommendation that significant disease be eradicated before irradiation of oral tissues. Two cases are reported to illustrate the complications that can arise in dentate patients following radiation to the oral cavity. Considerable suffering results from bone necrosis, which can be reduced by careful and rational dental diagnosis and treatment.