PROTOCOLO DE PREVENÇÃO E TRATAMENTO DA OSTEORRADIONECROSE EM PACIENTES COM CÂNCER DE CABEÇA E PESCOÇO
Authors: Santos Leticia Catarine Ferreira De Oliveira , Silva Sheila Aparecida , Tiglia Patrícia Ferreira , Santos Larissa Ibanhez , Lima Larissa S. Gomes De , Dornelas Marcos Vinicius , Varellis Maria Lucia Zarvos 
Published: December 2024

INTRODUCTION: Osteoradionecrosis (ORN) is a severe and debilitating complication that can occur in patients undergoing radiotherapy to treat head and neck cancers. Characterized by bone necrosis associated with radiation exposure, ORN results in chronic pain, persistent infections and, in severe cases, pathological fractures and disfigurement. Dental intervention plays a crucial role in both the prevention and treatment of ORN. Pre-radiotherapy dental assessment, including preventive dental procedures and the removal of compromised teeth, is essential to reduce the risk of ORN. During and after radiotherapy, continuous dental monitoring, strict maintenance of oral hygiene and the use of adjuvant therapies, such as hyperbaric oxygen therapy, are essential to minimize the risk of developing ORN. Modern radiotherapy techniques, such as intensity-modulated radiotherapy (IMRT), have been shown to be effective in reducing the radiation dose to healthy tissues, reducing the incidence of ORN. Collaboration between oncologists, dental surgeons and other health professionals is crucial for the effective management of osteoradionecrosis. Early identification of signs and symptoms allows for faster interventions and improves the patient's prognosis. In addition, continuous patient education on oral care is essential for long-term prevention. OBJECTIVE: This study aims to contribute to a better understanding of current practices and to the development of more effective approaches to the management of osteoradionecrosis, emphasizing the importance of the dental surgeon's role in the multidisciplinary team. MATERIAL AND METHOD: This is a literature review, which looked at articles published in the Medical Literature Analysis and Retrieval System Online (Medline/Pubmed) and Scientific Electronic Library Online (Scielo) databases. Terms such as: "Dentistry"; "Osteoradionecrosis"; "Cancer"; "Head and neck cancer"; "Treatment protocols" were used, covering the period from 2019 to 2023. Ro 2023, resulting in a total of 35 articles using the Qualis Periódicos evaluation criteria. RESULTS: Based on the data collected, it is possible to observe that the dental surgeon has the role of minimizing or even combating the progression of oral diseases that spread the evolution of ORN, through appropriate oral hygiene guidance that precedes the start of radiotherapy. Prior dental practice is of great importance so as not to compromise the methodology of the cancer treatment prescribed to the patient. CONCLUSION: The researched studies show that the dental surgeon, as a member of the oncology team, should work early in radiotherapy, with the aim of reducing the progression of the disease through oral hygiene guidance, periodic visits to the dentist, avoiding the progression of periodontal diseases and exodontia during the period of radiotherapy treatment. RESULTS: Based on the data collected, it is possible to observe that the dental surgeon has the role of minimizing or even combating the progression of oral diseases that spread the evolution of ORN, through appropriate oral hygiene guidance that precedes the start of radiotherapy. Prior dental practice is of great importance so as not to compromise the methodology of the cancer treatment prescribed to the patient. CONCLUSION: The researched studies show that the dental surgeon, as a member of the oncology team, should work early in radiotherapy, with the aim of reducing the progression of the disease through oral hygiene guidance, periodic visits to the dentist, avoiding the progression of periodontal diseases and exodontia during the period of radiotherapy treatment.