10.25241/stomaeduj.2018.5(3).art.5 – abstract

MAXILLOFACIAL SURGERY

Efficacy of a dental extraction policy designed to prevent osteoradionecrosis: a retrospective study in 100 oral cancer patients treated with intensity-modulated radiotherapy

DOI: https://doi.org/10.25241/stomaeduj.2018.5(3).art.5

Abstract

Introduction: The aim was to determine the efficacy of an extraction policy designed to prevent osteoradionecrosis (ORN) in dentate areas of the jaw after intensity-modulated radiotherapy (IMRT). A secondary aim was to establish whether our extraction policy risked unnecessary tooth extractions for areas designated to be not-at-risk of ORN.

Methodology: Data were retrospectively collected from 100 oral cancer patients, including the fate of 1430 individual teeth, from diagnosis to follow-up.

Results: Eight percent of IMRT-treated patients developed ORN; spontaneous cases (5) outnumbered those provoked by dental issues (3). All cases of ORN arose in regions irradiated with > 60 Gy, with the posterior mandible as preferred location, with non-spontaneous cases primarily due to progressive periodontitis. No correlation was found between the likelihood of extraction and cancer stage.

Conclusions: A more robust extraction policy of teeth affected with periodontitis and pocket depths of 4 – 5 mm might be advocated in molar areas predicted to receive > 60 Gy. Unfortunately, our study’s retrospective design precluded any detailed analyses of the underlying reasons for the 88 extractions that occurred at lower radiation dose thresholds; a more conservative approach may therefore be warranted for these low-risk areas.

Keywords: osteoradionecrosis, intensity-modulated radiotherapy, dosimetric distribution, tooth extraction, oral cancer.

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STATEMENT

STOMATOLOGY EDU JOURNAL (Stoma Edu J) is a new international dental journal whose main purpose is to inform researchers, educators, graduates, postgraduates and practitioners about the latest trends in the field, which followed, would bring immediate and lasting benefits to the patients; and about opinions of the most authorized specialists on what is best in current practice, for the good of both, patient and dentist.
STOMATOLOGY EDU JOURNAL (Stoma Edu J) is a peer-reviewed, open access international dental journal to be database indexed, meant to contribute to the development and completion of the medical training of practitioners as Dr. Greene Vardiman Black stated: “the professional man has no right to be other than a continual student”.
Open access journal, means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.