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Clinical Oral Investigations

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01-01-2020 | Oral Cancer | Original Article

The association between dental therapy timelines and osteoradionecrosis: a nationwide population-based cohort study

Authors: Yi-Fang Huang, Shih-Ping Liu, Chih-Hsin Muo, Chun-Hao Tsai, Chung-Ta Chang

Published in: Clinical Oral Investigations | Issue 1/2020

Abstract

Objectives

The study aimed to investigate the timeline association with specific dental therapy and osteoradionecrosis (ORN) in oral cancer patients.

Materials and methods

A total of 7394 oral cancer patients, including 198 ORN subjects, were retrieved from a Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan and were analyzed with the Cox proportional hazard regression to compare the ORN risk of individual dental treatments under different dental treatments.

Results

The initial dental treatment time significantly impacted on the risk of ORN in oral cancer patients (P<0.05). Pre-radiotherapy endodontic treatment and post-radiotherapy scaling or subgingival curettage increased ORN prevalence (hazard ratio [HR], 2.28 and 1.77, respectively). Endodontic treatment within 2 weeks to 1 month prior to radiotherapy increased the ORN risk by 5.83-fold. Dental scaling or subgingival curettage initialized from three to 6 months post-radiotherapy raised the ORN prevalence by 2.2-fold. Exodontia initialized within 2 weeks before radiotherapy (HR=1.49) or 1 to 3 months after radiotherapy (HR=2.63) greatly increased ORN prevalence. To perform oral surgery from 3 months pre-radiotherapy to 6 months after radiotherapy increased the 1.85-fold ORN risk. The chemotherapy combined oral surgery increased the ORN prevalence by 2.55-fold.

Conclusions

Timing of dental treatment, including pre-radiotherapy endodontic treatment, post-radiotherapy scaling or subgingival curettage, and oral surgery or exodontia before and after radiotherapy, could closely relate to ORN development in oral cancer patients.

Clinical relevance

Choosing right time to perform appropriate dental treatment could effectively reduce oral infection and ORN risk.

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Title: The association between dental therapy timelines and osteoradionecrosis: a nationwide population-based cohort study
Authors: Yi-Fang Huang
Shih-Ping Liu
Chih-Hsin Muo
Chun-Hao Tsai
Chung-Ta Chang
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Oral Cancer
Radiotherapy
Oral Cavity Carcinoma
Cytostatic Therapy
Periodontal Treatment
Caries
Dental Scaling
Dental Surgery
Published in: Clinical Oral Investigations / Issue 1/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-02866-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The association between dental therapy timelines and osteoradionecrosis: a nationwide population-based cohort study

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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