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Timing of development of osteoradionecrosis post head and neck radiotherapy: does a safe time interval exist for dental extraction?

Lookup NU author(s): Dr Charles Kelly

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Abstract

© Crown 2024.Introduction: Risk factors for developing osteoradionecrosis (ORN) are well known, but less is known about factors influencing the interval between radiotherapy and the onset of ORN. Also, it is unknown whether there is any specific period post-radiotherapy with a reduced probability of ORN when irradiated teeth require extraction. Purpose: The primary aim of this study was to identify factors influencing the interval in developing ORN in the following subgroups of patients: (1) patients who spontaneously developed ORN, (2) surgical-intervention-related ORN with a particular focus on patients after mandibulectomy. The secondary aim was to attempt to identify a possible time for safer dental intervention after primary treatment. Materials and methods: The authors retrospectively analysed 1608 head and neck cancer (HNC) patients treated in a single centre. Time intervals were measured from the end of radiotherapy to the development of ORN and further analysed in the subgroups listed above. Results: In all, 141 patients (8.8%) developed intra-oral ORN. Median time from radiotherapy to ORN development in the whole cohort was 9 months. Median interval for spontaneous ORN was 8 months, 6.5 months for intervention-related ORN, and 15 months for patients post-mandibulectomy. In patients who required dental extraction preradiotherapy, median interval of ORN onset was 5 months. Conclusion: In our study, a slightly higher proportion of patients with intervention developed ORN earlier in comparison with spontaneous ORN. The period from 12–18 months after radiotherapy was identified as having the highest probability of developing ORN in patients after mandibulectomy. A time for safer dental intervention after primary treatment was not identified.


Publication metadata

Author(s): Kovarik PD, Cvek J, Patil R, Macdougall C, Kelly C, Jackson M, McKenzie L, West N, Willis N, Kovarik JP, Anwar MN, Ellabban I, Shahid Iqbal M

Publication type: Article

Publication status: Published

Journal: Strahlentherapie und Onkologie

Year: 2024

Pages: epub ahead of print

Online publication date: 25/06/2024

Acceptance date: 26/05/2024

ISSN (print): 0179-7158

ISSN (electronic): 1439-099X

Publisher: Springer Science and Business Media Deutschland GmbH

URL: https://doi.org/10.1007/s00066-024-02251-5

DOI: 10.1007/s00066-024-02251-5


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