Paul,

That is a good summary of what we are dealing with. Do you have the info on cases of ORN developing even with pre-treatment extractions?

Here is what I've uncovered:

Some of the things I found support what the our RO says: watch and wait. There are treatment protocols for phosphate induced ONJ, not for radiation induced.. at least, not that I could find. But it looks like the Radiation Oncologist goes by the BRONJ protocol. Partial madiculectomy may be necessary in SEVERE cases, Then you need the multidisciplinary team.

ORN, the National Cancer Institue says, �no clear recommendations for treatment could be established on the basis of the literature.�

FRom my reading, it seems like the role of ENT is dealing with the trismus. That seems to be a separate problem that complicates treatment and oral hygiene.

Everything I read comes from Oral and Maxillofacial Surgeons, not Radiologists.