Can anyone speak to the issue of ORN risk dropping over time. As other oral structures slowly regain some function after radio, does this indicate a reducing risk of osteoradionecrosis?? I hope some of you can address this. Tom

Tom, it is my understanding that once the blood supply to the bone has been diminished by radiation, it will be forever more vulnerable. Temporary revascularization can be achieved by a series of hyperbaric oxygen treatments, without which any traumatic occurrences may not heal normally due to lack of blood supply.

I had hyperbaric treatments prior to the placement of lower titanium implants. If I elect to have upper ones placed at this later date, I will have to return to the hyperbaric chamber.

Probably not what you wanted to hear and I am sorry for that.

Tom, I was told very clearly by my oral surgeon that the risk of ORN never goes down after radiation. Anytime the bone is exposed, there is a risk, whether it is two years or twenty years later. He also told me the same thing Joanna said about hyperbaric oxygen --it temporarily protects (usually) against ORN if you need oral surgery but probably doesn't change the longer term risk--you'd need it again for it to help again.

Nelie

What is ORN?

Thanks, Vickie

Tom,

I was also under the impression that the risk doesn't lessen over time. I've had a couple of fairly standard procedures in the last two years with my oral surgeon and periodontist, and I know they both were very careful to assess the ORN risk before going ahead with them.

Vickie,

ORN is osteoradionecrosis (you can find quite a bit about it if you search this site). It is basically "bone death" that can occur post-radiation in areas such as the jaw if the bone is exposed during major dental procedures.

Cathy

Vickie, ORN is Osteoradionecrosis, which means bone death due to lack of blood supply, caused by exposure to radiation. This is a very serious business that is difficult to treat - by cutting out the affected bone. Docs never joke about it, and OC patients need to be aware of the risk.

Vickie,

The following may help you:

Osteoradionecrosis...bone that has received doses of radiation may lack the ability to repair itself after trauma. Radiation destroys the blood vessels in the area causing a reduction of circulation to the area of oxygen and other nutrients. This then will prevent normal healing in that area if the bone is injured.

Hyperbaric oxygen to the area will stimulate new blood vessel growth and therefore stimulate bone healing.

Without hyperbaric oxygen, removal of a tooth or placement of an implant will probably result in bone that won't heal.

This is a good article: http://www.virginiamason.org/dbHyperbaricOxygen/sec181033.htm

Hope this has been helpful.

Jerry

Thank you Joanna, Nelie, Cathy and Vickie. I really appreciate the information. Tom

Tom,

I've had 20 dives so far and then had dental work done. I just had four of my lower teeth (front) and one molar removed on Friday. Now I start back up with HBO tomorrow to finish with 10 more dives. All is well except for some swelling. Not much pain. I was really worried about the ORN, and I guess I still should be. Having the HBO really eases my mind to a degree. One good thing that came about because of the HBO is that the fistula that I have is almost all the way healed.

John

John, Thanks for the HBO info. I have not had that treatment and know very little about it. Is there a limited number of dives you can take? Will you be able to go in for more after some time has passed? Its very cool that you got some real healing from the time you spent, PLUS got some dental work done. I'm thinking about implanted hooks for dentures, but I'm fearful of the ORN. Be strong. Tom