Jerry,

I have a father & son team. The father is the oral surgeon and the son is the dentist. I will be put under for the procedure. I have to have a few teeth removed that I had root canals on years ago. I also have a tooth that I broke just prior to my radiation. I have a temporary filling in it. The dentist thinks I'll have to have it pulled as well. I had a pandoramic? x-ray done on my jaw. I have to meet with them again next week to finalize the plans.

John

John, Just curious also since I also have teeth that have moved around some since pre-radiation, have you had hyperbaric oxygen therapy before this? If not, what about the risk of ORN?

Nelie

John and Nelie - I too am interested in the possibilities. ORN is a real danger for all of us with night-glow jaws. Does anyone have history with reconstructive jaw work AFTER rad? Anybody have any experience with ORN? Has anyone been able to get a refund for the stupid mask?? Tom

Please excuse my ignorance, but what is ORN / hyperbaric oxygen therapy? It's all Greek to me!

John

Got a good one for you guys. While I was in the hospital last year recuperating from my surgery. I somehow managed to have kidney stones. Made me forget about the pain I had from the surgery in a heart beat. Never before in my life had I experienced THAT kind of pain. It was excrutiating. Talk about adding insult to injury. I couldn't talk because I still had my trach in, but I let the nurses know in no uncertain terms that I needed something done and done in a hurry.

John

John - ORN is (I think) Osteo-Radio-Necrosis. Its a dangerous degenerative condition that can occur in radiated tissue. I don't know the mechanism, but small sores or injuries do not heal, rather they grow very large and become threatening to surrounding tissues.

ORN in the jaw can cause the complete loss of the entire jaw. The radiation so damages the blood vessels that they cannot supply injured sights with healing fluids - precipitating the catastrophic loss of tissue. Its really ugly stuff. It is the fear of ORN that keeps most of us from risking any surgeries in the radiation field. It can be risky.

Hyperbaric Oxygen treatment is a mechanical method to attempt to oxygenate damaged tissue. It is, I believe, the treatment of choice to try and stop ORN from advancing.

Please seek better definitions of both of these terms. My knowledge is limited, and you need solid information about both of them. Your doc can help you. Hope this helps a little. Tom

John, For what it's worth, my oral surgeon, who has a lot of experience treating patients who have had oral radiaton, says some of his patients who have had oral radiation choose to have oral surgery such as tooth extractions without Hyperbaric oxygen therapy (HBO) and take their chances with ORN, especially if he believes their risk is low because of their radiation plan (apparently with IMRT radiation, less of the jaw is likely to be severly damaged by radiation than with general field radiation). I think this is in part because anyone living here would have to drive oevr an hour each way to GET HBO and you have to go every day for several weeks of treatment. He says often they don't have a problem, but once in a while they do.

Apparently the standard the recommendation is that you have a certain number of HBO therapy sessions before any surgery that affects the jaw (O'm thinking he said 30 but I'm not at all sure I'm recalling that right) and then a few more after in order to be sure the jaw is going to heal OK.

It also apparently helps heal soft tissue that may be permanently injured from radiation. There are other folks here who can say more about that.

Nelie

Hi,
I'm not a dentist or medical at all but since no one else has responded to your questions about HBO and ORN I wil try.

HBO is hyperbaric oyxgen treatments. I was told prior to my radiation that these HBO treatments, about 30 of them, would be an absolute necessity before I had any dental surgery after having radiation. This is the only reason that I allowed them to pull some teeth before radiation.

ORN is osteoradionecrous (sp?) which is basically the bone dying and can lead to major problems. I think you need to get a second opinion before you dive into this dental surgery without HBO.

I havent' read it, but try the dental section of this web site and see what it tells you.

Please someone else more qualified to address this, update this issue.

Thanks,
Eileen

Hi J,

Interesting set-up with the father and son team. I was wondering how you would have all the work done by a surgeon. Makes sense. We do the same thing in our office, but not by a father and son. Good luck.


It is "panoramic" x-ray, just like it is used in photography.

Jerry

Jerry - Can you address the issue of ORN in more detail? My knowledge of it is very limited and I'd like to know more. What are the risks? Nelie posted about IMRT limiting the risks. How does that work? Your input would be very welcome. Tom