Dental extractions and radiotherapy in head and neck oncology: review of the literature
- 18 December 2007
- journal article
- review article
- Published by Wiley in Oral Diseases
- Vol. 14 (1), 40-44
- https://doi.org/10.1111/j.1601-0825.2006.01351.x
Abstract
Management of irradiated patients with cancer in the head and neck region represents a challenge for multidisciplinary teams. Radiotherapy promotes cellular and vascular decrease that results in a low response rate in the healing. Consequently, surgical procedures in irradiated tissues present high rates of complication. Osteoradionecrosis (ORN) is the most severe sequelae caused by radiotherapy. It is associated with previous extractions especially those carried out post-irradiation. The management of this side effect is difficult and can result in bone or soft tissue loss, affecting the quality of life. The literature regarding dental extractions performed before and after head and neck radiotherapy was evaluated, focusing on indications, criteria, surgical techniques and adjunctive therapies such as antibiotics and hyperbaric oxygen. Osteoradionecrosis can be minimized by oral evaluation and care prior to irradiation and healing time which allows tissue repair until the commencement of radiotherapy. In dental extractions realized after irradiation, minimal trauma, alveolectomy, primary alveolar closure and adjunctive therapies are recommended. Patients must be evaluated before radiation therapy and at that time all unrestorable teeth and/or teeth with periodontal problems must be extracted to reduce the post-radiotherapy exodontias that contribute to ORN. Once dental extractions become unavoidable after irradiation, additional care is needed.This publication has 25 references indexed in Scilit:
- Hyperbaric Oxygen Therapy for Radionecrosis of the Jaw: A Randomized, Placebo-Controlled, Double-Blind Trial From the ORN96 Study GroupJournal of Clinical Oncology, 2004
- Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients—a report of a thirty year retrospective reviewInternational Journal of Oral & Maxillofacial Surgery, 2003
- A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavityBritish Dental Journal, 2002
- Postradiation dental extractions without hyperbaric oxygenOral Surgery, Oral Medicine, Oral Pathology, 1991
- Studies in the radiobiology of osteoradionecrosis and their clinical significanceOral Surgery, Oral Medicine, Oral Pathology, 1987
- Osteonecrosis: Study of the relationship of dental extractions in patients receiving radiotherapyHead & Neck Surgery, 1987
- Dental extractions in relation to radiation therapy of 224 patientsInternational Journal of Oral & Maxillofacial Surgery, 1987
- Preradiation dental extractions and the incidence of bone necrosisHead & Neck Surgery, 1983
- Dental extractions in the irradiated patientSpecial Care in Dentistry, 1981