Hi Mike, I have heard of this problem with primary bt (anaplastic astrocytomas, gliomas, GBMs, etc.) patients who have had radiation treatment. It depends on the type of radiation used and the amount of rads. It may also be because you had your radiation treatment over twenty years ago. I googled " osteonacropathy" and the only thing that came up was your post!![]() "Osteo" means bone and "-pathy" means damage, disease, etc. Maybe bone necrosis? She may have meant "osteoradionecrosis." Radiation can cause damage and necrosis to the radiation area. That may be what your oral surgeon is concerned about. Here is information I found about bone necrosis: Almost all chronic radiation complications result from scarring and narrowing of the blood vessels within the area which has received treatment. If this process progresses to the point that the normal tissues are no longer receiving an adequate blood supply, death or necrosis of these tissues can occur. Chronic radiation damage is called "osteoradionecrosis" when the bone is damaged and "soft tissue radionecrosis" if it is muscle, skin or internal organs which have been damaged by the radiation. Since the 1970s, surgeons of the head and neck region have come to recognize the value of hyperbaric oxygen treatments in treating damage of the jaw bone due to radiation therapy. Hyperbaric oxygen has had some of its most dramatic successes in treating or preventing damage to the jaw bone as a result of radiation treatments. Now, hyperbaric oxygen therapy has been used to treat radiation therapy damage of the brain, muscle and other soft tissues of the face and throat, the chest wall, abdomen and pelvis The high dose oxygen provided in the hyperbaric chamber is carried in the patientÂ’s circulation to the site of injury to assist in the repair of the damage done by the narrowing and scarring of the blood vessels. Each treatment typically takes one to two hours, and usually 30-40 daily treatments are needed for healing radiation damage.
http://www.virginiamason.org/dbHyperbaricOxygen/sec180774.htm ===================== Due to the deceased blood supply, especially in your lower jaw, should you ever need an extraction or surgery you are at risk for literally not healing. Such a problem can cause massive destruction of the jaw bone, and can even be fatal. This is the reason for discriminatory examination and aggressive treatment before radiation therapy. DO NOT LET A DENTIST EXTRACT A TOOTH WITHOUT CONSULTING YOUR RADIATION ONCOLOGIST, FOR THE REST OF YOUR LIFE AFTER RADIATION THERAPY.
When indicated or absolutely necessary, extractions and other surgical treatments, including bone grafts and implants, can be accomplished with a special pre-treatment called hyperbaric oxygen, or HBO. This treatment increases the blood supply and allows for improved healing. We have been able to give patients a second chance with careful use of this treatment and judicious use of implants.
The seriousness of this complication must be understood by your dentist. Second opinions or specialist consultations are recommended prior to acting on any invasive or traumatic treatment to the lower jaw. For more information: | 