Osteoradionecrosis incidence in pre-radiation teeth extractions: A prospective study.

Autor: Rupe C; Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy., Gioco G; Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy., Massaccesi M; Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy., Tagliaferri L; Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy., Pastore F; Department of Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy., Micciché F; Oncologic Radiotherapy, Ospedale Isola Tiberina Gemelli Isola, Rome, Italy., Galli J; Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy., Mele D; Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy., Specchia ML; Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy., Cassano A; Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy., Cordaro M; Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy., Lajolo C; Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli-IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy.
Jazyk: angličtina
Zdroj: Oral diseases [Oral Dis] 2024 Nov; Vol. 30 (8), pp. 5129-5139. Date of Electronic Publication: 2024 Apr 09.
DOI: 10.1111/odi.14941
Abstrakt: Aims: To evaluate osteoradionecrosis (ORN) incidence in a cohort of patients undergoing tooth extraction (TE) before radiotherapy (RT) for head and neck cancers.
Methods: The study protocol was approved by the Ethics Committee of Università Cattolica del Sacro Cuore (ID-2132) and registered at clinicaltrials.gov (ID: NCT04009161). TE was performed in case of signs of pericoronitis, periapical lesions, restorative impossibility, severe periodontitis. ORN was defined as exposed bone at an unhealed post-extraction socket in the absence of oncological recurrence. The RT plans were reviewed, and each post-extractive socket was contoured to calculate the received radiation dose.
Results: In total, 156 patients with 610 TE were enrolled. The mean follow-up was 567 days. ORN was diagnosed in four patients (2.6% of patients and 0.7% of TE). Need for osteotomy and radiation dose at the extraction site were associated with ORN (OR for osteotomy: 21.9, 95% CI: 2.17-222.2, p = 0.009; OR for RT dose: 1.1, 95% CI: 1-1.15, p = 0.05).
Conclusions: TE appears to be a significant risk factor for ORN, particularly when osteotomy is required, and post-extraction sockets receive a high RT dosage. This study proposes a decision-making algorithm for TE and outlines a straightforward surgical protocol.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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