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Hard tissue necrosis

Bone necrosis (osteonecrosis) in the head & neck region often occurs in combination with necrosis of adjacent soft tissues such as the skin or the lining of the mouth (mucosa).

The treatment options for hard tissue necrosis include:

The most appropriate treatment scheme(s) for osteonecrosis are not only dictated by the extent and location of the lesion(s) as the above list of escalating treatment options may suggest. The underlying cause is another important factor for choosing the best possible treatment scheme, alongside considerations of general fitness for major surgery and, in some circumstances, life expectancy.

At the time of writing (2018), the most common causes of bone necrosis in the maxillofacial region are radiotherapy applied to the head & neck region (osteoradionecrosis, ORN), and various medication-treatment schemes with antiresorptive agents for the management of various bone conditions such as osteoporosis, bone metastases, or primary bone malignancies (medication-related osteonecrosis of the jaws, MRONJ). With these two risk factors well documented and severe osteonecrosis being a debilitating condition, any (improved) prevention is the preferred option whenever possible.

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