Predictors of Osteoradionecrosis Following Irradiated Tooth Extraction

Overview

Journal Radiat Oncol

Publisher Biomed Central

Specialties Oncology
Radiology

Date 2021 Jul 15

PMID 34261515

Citations 10

Authors

Szu Ching Khoo

Syed Nabil

Azizah Ahmad Fauzi

Siti Salmiah Mohd Yunus

Wei Cheong Ngeow

Roszalina Ramli

Affiliations

Soon will be listed here.

Abstract

Background: Tooth extraction post radiotherapy is one of the most important risk factors of osteoradionecrosis of the jawbones. The objective of this study was to determine the predictors of osteoradionecrosis (ORN) which were associated with a dental extraction post radiotherapy.

Methods: A retrospective analysis of medical records and dental panoramic tomogram (DPT) of patients with a history of head and neck radiotherapy who underwent dental extraction between August 2005 to October 2019 was conducted.

Results: Seventy-three patients fulfilled the inclusion criteria. 16 (21.9%) had ORN post dental extraction and 389 teeth were extracted. 33 sockets (8.5%) developed ORN. Univariate analyses showed significant associations with ORN for the following factors: tooth type, tooth pathology, surgical procedure, primary closure, target volume, total dose, timing of extraction post radiotherapy, bony changes at extraction site and visibility of lower and upper cortical line of mandibular canal. Using multivariate analysis, the odds of developing an ORN from a surgical procedure was 6.50 (CI 1.37-30.91, p = 0.02). Dental extraction of more than 5 years after radiotherapy and invisible upper cortical line of mandibular canal on the DPT have the odds of 0.06 (CI 0.01-0.25, p < 0.001) and 9.47 (CI 1.61-55.88, p = 0.01), respectively.

Conclusion: Extraction more than 5 years after radiotherapy, surgical removal procedure and invisible upper cortical line of mandibular canal on the DPT were the predictors of ORN.

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Dignam P, Elshafey M, Jeganathan A, Foo M, Park J, Ratnaweera M Int J Dent. 2024; 2024:7712829.

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Melerowitz L, Sreenivasa S, Nachbar M, Stsefanenka A, Beck M, Senger C Clin Transl Radiat Oncol. 2024; 47:100780.

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