{"entity":{"id":"osteoradionecrosis","kind":"term","name":"Osteoradionecrosis of the jaw","aka":["ORN","Osteoradionecrosis","Radiation osteonecrosis","Jaw osteoradionecrosis"],"tldr":"Bone in the jaw that was in the path of radiotherapy for a head and neck cancer can lose its blood supply and break down, sometimes years later and often after a tooth is taken out. Dental treatment before radiotherapy and careful dental care afterwards lower the risk.","summary":"The ISOO-MASCC-ASCO guideline (2024) addresses osteoradionecrosis of the jaw secondary to head and neck radiotherapy. From a systematic review of 80 studies, the panel rated its recommendations on best practices for prevention and on surgical management as evidence-based with strong evidence, relied on informal consensus elsewhere, made no recommendation on leukocyte- and platelet-rich fibrin or photobiomodulation for prevention, and judged hyperbaric oxygen for prevention or management largely unjustified. NCI PDQ (Oral Complications of Cancer Therapies) sets out the dental assessment before high-dose head and neck radiotherapy, scheduled as early as possible so that any extractions can heal before treatment, and lists monitoring for osteoradionecrosis among the follow-up tasks. Medication-related osteonecrosis of the jaw is defined to exclude people who have had radiotherapy to the jaws.","asOf":"2026-11-11","links":[{"label":"Peterson et al., Prevention and management of osteoradionecrosis in patients with head and neck cancer treated with radiation therapy: ISOO-MASCC-ASCO guideline (J Clin Oncol 2024)","url":"https://europepmc.org/article/MED/38691821"},{"label":"NCI PDQ: Oral Complications of Cancer Therapies, health professional version","url":"https://www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat/oral-complications-hp-pdq"}],"tags":["supportive-care-gaps-2026-11"],"related":["medication-related-osteonecrosis-of-the-jaw"],"cancers":["head-and-neck"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["radiotherapy","late-effects"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"provenance":{"editedBy":"OnCo supportive care gap fill (CDC, NHSN, SHEA, Society for Endocrinology, ESMO, MASCC, ASCO, ASTCT, NCI PDQ, Europe PMC)","editedOn":"2026-11-11"},"category":"Side effects"},"route":"/terms/osteoradionecrosis/","neighbours":{"term":[{"id":"late-effects","kind":"term","name":"Late effects and survivorship toxicity","route":"/terms/late-effects/"},{"id":"medication-related-osteonecrosis-of-the-jaw","kind":"term","name":"Osteonecrosis of the jaw (medication-related, MRONJ)","route":"/terms/medication-related-osteonecrosis-of-the-jaw/"},{"id":"radiotherapy","kind":"term","name":"Radiotherapy","route":"/terms/radiotherapy/"}],"cancer":[{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"}]}}