Adjuvant therapy in osteoradionecrosis management: case reports

Osteoradionecrosis is a chronic complication of head and neck radiotherapy. It is characterized by necrotic bone exposure in previously irradiated areas. The clinical manifestations range from asymptomatic bone exposure to severe infections and pathological fractures. We report the clinical outcomes of adjunctive therapies for osteoradionecrosis management. Three male patients diagnosed with osteoradionecrosis following head and neck radiotherapy underwent treatment with a weekly ozone therapy protocol that included ozonated water irrigation, gas infiltration, and topical ozonated oil application. One patient with severe disease required a combination of surgical debridement and platelet-rich fibrin membrane placement. All the patients demonstrated progressive epithelialization, infection control, and accelerated wound healing. These results suggest that ozone therapy is a valuable strategy for enhancing tissue regeneration and improving wound healing, whether used alone or in combination with surgical procedures and platelet-rich fibrin. Altogether, these findings reinforce the potential of multimodal approaches in the clinical management of osteoradionecrosis.