How critical is the interval between extractions and irradiation in patients with head and neck malignancy?

A total of sixty-two patients with head and neck malignancy who had teeth extracted prior to irradiation therapy were studied. Only one in this group of sixty-two patients developed posttherapy necrosis, and this instance was in no way related to the pre-irradiation extractions. Our experience with patients who have undergone extractions prior to radiotherapy indicates that exodontia may not be, within itself, associated with increased serious postirradiation sequelae. The incidence of osteoradionecrosis in these patients is extremely low. Further, our data do not indicate a critical time period for healing of extraction sockets prior to initiation of radiotherapy. When the state of the underlying disease allows, a healing time of 10 to 14 days should be granted when teeth are extracted prior to irradiation. This recommended interval is only a guideline, since a shorter healing time does not entail a significantly greater risk and should therefore not be arbitrarily classified as inappropriate.