Treatment of Osteoradionecrosis of the Jaw with Ozone in the Form of Oil-based Gel: 1-year follow-up

Aim: Osteoradionecrosis of the jaws (ORNJs) is aseptic bone necrosis that develops in post-irradiated bone tissue of patients who underwent radiotherapy for head-neck tumors. The present study aims to clinically assess the regenerative ability of the ozone in the form of oil-based gel applied to the exposed bone area in the treatment of ORNJ. Materials and methods: Eight patients who underwent radiotherapy for the treatment of cervical or neck cancer were diagnosed with ORN of the jaws at our Department, for a total of 11 sites of necrotic bone exposure (3 patients were diagnosed with more than one site of osteoradionecrosis). In the therapeutic protocol, the exposed bone lesion and osteomucosal margin were cleaned with manual debridement. Then the ORN lesion was treated with topical applications of ozone delivered as oil suspension (Ozosan® - Sanipan, Clivio, Italy) on the exposed bone for 10 minutes. The application was repeated each week until movement of the necrotic fragment was noted Results: In six patients on 8 (75%) lesions resolved with complete mucosal healing with 3 to 19 ozone applications. Total sequestration of the necrotic bone with spontaneous expulsion was observed. One patient improved his conditions shifting from a stage B2S1 to B1S1 according to He et al. classification. A patient only worsened his conditions with treatment. No toxicity was reported or observed. Conclusion: These results showed the efficacy of ozone oil suspensions in the non-invasive treatment of ORN, probably related to its properties of stimulation of local revascularization and antibacterial activity, and the good tolerability of the related protocol used.