Table 2

Osteoradionecrosis of the jaw staging systems

AuthorYearStaging system
Marx [12]1983

Based on treatment site‐specific response to HBO

 

Stage I: evidence of complete clinical improvement following 30 dives of HBO

 

Stage II: no evidence of clinical improvement following 30 dives of HBO but clinical improvement following transoral sequestrectomy with primary mucosal closure and an additional 10 dives of HBO

 

Stage III: presence of orocutaneous fistula or oral dehiscence despite a minimum of 30 dives of HBO and surgical resection

 

Stage III‐R: following a total of 60 accumulated dives or until healthy mucosal closure, patients are advanced to this stage and receive an additional 20 HBO dives in preparation for bone graft reconstruction

Epstein et al. [41]1987

Based on clinical progression of ORN

 

Stage I: healed/resolved

 

Stage II: chronic/persistent

 

Stage III: active/progressive

Schwartz and Kagan [42]2002

Based on clinical and radiographic findings of mandibular ORN

 

Stage I: superficial mandibular involvement

 

Stage II: localized mandibular involvement

 

Stage III: diffuse mandibular involvement

Notani et al. [23]2003

Based on the anatomical extent of ORN

 

Stage I: confined to the alveolar bone

 

Stage II: extent above the mandibular alveolar canal

 

Stage III: extent below the level of the mandibular alveolar canal with a skin fistula and/or pathologic fracture

AuthorYearStaging system
Marx [12]1983

Based on treatment site‐specific response to HBO

 

Stage I: evidence of complete clinical improvement following 30 dives of HBO

 

Stage II: no evidence of clinical improvement following 30 dives of HBO but clinical improvement following transoral sequestrectomy with primary mucosal closure and an additional 10 dives of HBO

 

Stage III: presence of orocutaneous fistula or oral dehiscence despite a minimum of 30 dives of HBO and surgical resection

 

Stage III‐R: following a total of 60 accumulated dives or until healthy mucosal closure, patients are advanced to this stage and receive an additional 20 HBO dives in preparation for bone graft reconstruction

Epstein et al. [41]1987

Based on clinical progression of ORN

 

Stage I: healed/resolved

 

Stage II: chronic/persistent

 

Stage III: active/progressive

Schwartz and Kagan [42]2002

Based on clinical and radiographic findings of mandibular ORN

 

Stage I: superficial mandibular involvement

 

Stage II: localized mandibular involvement

 

Stage III: diffuse mandibular involvement

Notani et al. [23]2003

Based on the anatomical extent of ORN

 

Stage I: confined to the alveolar bone

 

Stage II: extent above the mandibular alveolar canal

 

Stage III: extent below the level of the mandibular alveolar canal with a skin fistula and/or pathologic fracture

Abbreviations: HBO, hyperbaric oxygen; ORN, osteoradionecrosis.

Table 2

Osteoradionecrosis of the jaw staging systems

AuthorYearStaging system
Marx [12]1983

Based on treatment site‐specific response to HBO

 

Stage I: evidence of complete clinical improvement following 30 dives of HBO

 

Stage II: no evidence of clinical improvement following 30 dives of HBO but clinical improvement following transoral sequestrectomy with primary mucosal closure and an additional 10 dives of HBO

 

Stage III: presence of orocutaneous fistula or oral dehiscence despite a minimum of 30 dives of HBO and surgical resection

 

Stage III‐R: following a total of 60 accumulated dives or until healthy mucosal closure, patients are advanced to this stage and receive an additional 20 HBO dives in preparation for bone graft reconstruction

Epstein et al. [41]1987

Based on clinical progression of ORN

 

Stage I: healed/resolved

 

Stage II: chronic/persistent

 

Stage III: active/progressive

Schwartz and Kagan [42]2002

Based on clinical and radiographic findings of mandibular ORN

 

Stage I: superficial mandibular involvement

 

Stage II: localized mandibular involvement

 

Stage III: diffuse mandibular involvement

Notani et al. [23]2003

Based on the anatomical extent of ORN

 

Stage I: confined to the alveolar bone

 

Stage II: extent above the mandibular alveolar canal

 

Stage III: extent below the level of the mandibular alveolar canal with a skin fistula and/or pathologic fracture

AuthorYearStaging system
Marx [12]1983

Based on treatment site‐specific response to HBO

 

Stage I: evidence of complete clinical improvement following 30 dives of HBO

 

Stage II: no evidence of clinical improvement following 30 dives of HBO but clinical improvement following transoral sequestrectomy with primary mucosal closure and an additional 10 dives of HBO

 

Stage III: presence of orocutaneous fistula or oral dehiscence despite a minimum of 30 dives of HBO and surgical resection

 

Stage III‐R: following a total of 60 accumulated dives or until healthy mucosal closure, patients are advanced to this stage and receive an additional 20 HBO dives in preparation for bone graft reconstruction

Epstein et al. [41]1987

Based on clinical progression of ORN

 

Stage I: healed/resolved

 

Stage II: chronic/persistent

 

Stage III: active/progressive

Schwartz and Kagan [42]2002

Based on clinical and radiographic findings of mandibular ORN

 

Stage I: superficial mandibular involvement

 

Stage II: localized mandibular involvement

 

Stage III: diffuse mandibular involvement

Notani et al. [23]2003

Based on the anatomical extent of ORN

 

Stage I: confined to the alveolar bone

 

Stage II: extent above the mandibular alveolar canal

 

Stage III: extent below the level of the mandibular alveolar canal with a skin fistula and/or pathologic fracture

Abbreviations: HBO, hyperbaric oxygen; ORN, osteoradionecrosis.

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