Yuka Kojima1, Souichi Yanamoto2, Masahiro Umeda2, Yumiko Kawashita3, Izumi Saito4, Takumi Hasegawa4, Takahide Komori4, Nobuhiro Ueda5, Tadaaki Kirita5, Shin-Ichi Yamada6, Hiroshi Kurita6, Yasuko Senga7, Yasuyuki Shibuya7, Hiroshi Iwai8. 1. Department of Dentistry and Oral Surgery, Kansai Medical University, Osaka, Japan. Electronic address: kojimayk@hirakata.kmu.ac.jp. 2. Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 3. Perioperative Oral Management Center, Nagasaki University Hospital, Nagasaki, Japan. 4. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. 5. Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara, Japan. 6. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Nagano, Japan. 7. Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 8. Department of Otolaryngology-Head and Neck Surgery, Kansai Medical University, Osaka, Japan.
Abstract
OBJECTIVE: Osteoradionecrosis of the jaw is a serious late adverse event in patients with head and neck cancer undergoing radiotherapy. The aim of this study is to investigate the relationship between dental status and development of osteoradionecrosis. STUDY DESIGN: Multicenter, retrospective observational study. A total of 392 patients with head and neck cancer who underwent radiotherapy were investigated for correlations between the development of osteoradionecrosis and various factors. The cumulative occurrence rate of osteoradionecrosis was calculated by the Kaplan-Meier method and analyzed by Cox regression and log-rank test. RESULTS: Osteoradionecrosis developed in 30 of 392 patients. In 23 patients, osteoradionecrosis occurred in the mandibular molar region. A univariate analysis showed that oral or oropharyngeal cancer, jaw radiotherapy dose exceeding 50 Gy, periapical periodontitis, and tooth extraction after radiotherapy were significantly correlated with the occurrence of osteoradionecrosis. Among these, oral and oropharyngeal cancer, periapical periodontitis, and tooth extraction after radiotherapy were significant independent risk factors by multivariate analysis. Further, caries that occurred after radiotherapy and progressed rapidly, resulting in periapical periodontitis, carious stump, or extraction, was a major cause of osteoradionecrosis. CONCLUSION: Extraction of mandibular molars with periapical periodontitis before radiotherapy and strict dental management after radiotherapy may reduce the risk of osteoradionecrosis.
OBJECTIVE:Osteoradionecrosis of the jaw is a serious late adverse event in patients with head and neck cancer undergoing radiotherapy. The aim of this study is to investigate the relationship between dental status and development of osteoradionecrosis. STUDY DESIGN: Multicenter, retrospective observational study. A total of 392 patients with head and neck cancer who underwent radiotherapy were investigated for correlations between the development of osteoradionecrosis and various factors. The cumulative occurrence rate of osteoradionecrosis was calculated by the Kaplan-Meier method and analyzed by Cox regression and log-rank test. RESULTS:Osteoradionecrosis developed in 30 of 392 patients. In 23 patients, osteoradionecrosis occurred in the mandibular molar region. A univariate analysis showed that oral or oropharyngeal cancer, jaw radiotherapy dose exceeding 50 Gy, periapical periodontitis, and tooth extraction after radiotherapy were significantly correlated with the occurrence of osteoradionecrosis. Among these, oral and oropharyngeal cancer, periapical periodontitis, and tooth extraction after radiotherapy were significant independent risk factors by multivariate analysis. Further, caries that occurred after radiotherapy and progressed rapidly, resulting in periapical periodontitis, carious stump, or extraction, was a major cause of osteoradionecrosis. CONCLUSION: Extraction of mandibular molars with periapical periodontitis before radiotherapy and strict dental management after radiotherapy may reduce the risk of osteoradionecrosis.
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Authors: Suad Aljohani; Riham Fliefel; Teresa Franziska Brunner; Aristeidis Chronopoulos; Nada Binmadi; Sven Otto Journal: J Int Med Res Date: 2022-06 Impact factor: 1.573
Authors: Rajesh V Lalla; Nathaniel S Treister; Thomas P Sollecito; Brian L Schmidt; Lauren L Patton; Erika S Helgeson; Alexander Lin; Cynthia Rybczyk; Robert Dowsett; Upendra Hegde; Timothy S Boyd; Thomas G Duplinsky; Michael T Brennan Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2022-01-31
Authors: Lisanne V van Dijk; Abdelrahman A Abusaif; Jillian Rigert; Mohamed A Naser; Katherine A Hutcheson; Stephen Y Lai; Clifton D Fuller; Abdallah S R Mohamed Journal: Int J Radiat Oncol Biol Phys Date: 2021-06-10 Impact factor: 8.013