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Oral and Maxillofacial Surgery
Published in: Oral and Maxillofacial Surgery 4/2016

01-12-2016 | Original Article

Cause and occurrence timing of osteoradionecrosis of the jaw: a retrospective study focusing on prophylactic tooth extraction

Authors: Satoshi Wanifuchi, Masaya Akashi, Yasuo Ejima, Hirotaka Shinomiya, Tsutomu Minamikawa, Shungo Furudoi, Naoki Otsuki, Ryohei Sasaki, Ken-ichi Nibu, Takahide Komori

Published in: Oral and Maxillofacial Surgery | Issue 4/2016

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Abstract

Purpose

This retrospective study aimed to analyze the relationship between tooth extraction and osteoradionecrosis (ORN) occurrence. The irradiation field, dose, and time interval between radiotherapy (RT) and ORN were reviewed. We also discuss appropriate guidelines for prophylactic tooth extraction.

Methods

A total of 33 patients treated for grade ≥2 (clinical) ORN in our department from 2002 to 2014 were enrolled. The following epidemiological data were retrospectively gathered: age, sex, histological diagnosis, primary tumor sites, radiation dose, chemotherapy, site of ORN, relationship between tooth extraction and ORN occurrence, and time interval between tooth extraction and the initiation or end of RT.

Results

Twenty-one percent of ORN cases resulted from tooth extraction. The most common site of ORN (82 %) was the mandibular molar region. About half of ORN cases (49 %) occurred within 2 years after RT. All patients who received tooth extraction after RT developed ORN (100 %) independently of time interval between tooth extraction and the end of RT (median interval, 37.5 months; range, 27–120 months). In contrast, only 50 % of patients who received tooth extraction before RT developed ORN. There may have been an association between the irradiation field and the site of ORN development

Conclusions

ORN occurrence due to tooth extraction was 21 %. Occurrence timing of ORN did not depend on time interval between tooth extraction and the end of RT. The irradiation field is certainly related to the site of ORN; therefore, prophylactic tooth extraction should be performed in consideration of the proposed radiation field and dose.
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Metadata
Title
Cause and occurrence timing of osteoradionecrosis of the jaw: a retrospective study focusing on prophylactic tooth extraction
Authors
Satoshi Wanifuchi
Masaya Akashi
Yasuo Ejima
Hirotaka Shinomiya
Tsutomu Minamikawa
Shungo Furudoi
Naoki Otsuki
Ryohei Sasaki
Ken-ichi Nibu
Takahide Komori
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 4/2016
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-016-0570-5

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