Background Tooth extraction post radiotherapy is one of the most important risk factors of osteoradionecrosis of the jawbones. The objective of this study was to determine the predictors of osteoradionecrosis (ORN) which were associated with a dental extraction post radiotherapy. Methods A retrospective analysis of medical records and dental panoramic tomogram (DPT) of patients with a history of head and neck radiotherapy who underwent dental extraction between August 2005 to October 2019 was conducted. Results Seventy-three patients fulfilled the inclusion criteria. 16 (21.9%) had ORN post dental extraction and 389 teeth were extracted. 33 sockets (8.5%) developed ORN. Univariate analyses showed significant associations with ORN for the following factors: tooth type, tooth pathology, surgical procedure, primary closure, target volume, total dose, timing of extraction post radiotherapy, bony changes at extraction site and visibility of lower and upper cortical line of mandibular canal. Using multivariate analysis, the odds of developing an ORN from a surgical procedure was 6.50 (CI 1.37–30.91, p = 0.02). Dental extraction of more than 5 years after radiotherapy and invisible upper cortical line of mandibular canal on the DPT have the odds of 0.06 (CI 0.01–0.25, p < 0.001) and 9.47 (CI 1.61–55.88, p = 0.01), respectively. Conclusion Extraction more than 5 years after radiotherapy, surgical removal procedure and invisible upper cortical line of mandibular canal on the DPT were the predictors of ORN.

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Background: Dental radiograph acts as an adjunct to the clinical examination that aids the dentist to evaluate and definitively diagnose many oral diseases and conditions. Bitewings and periapical radiographs are the two intraoral radiographs that are commonly used in paediatric dental clinic. Aim: To assess the quality, justification and reporting of intraoral radiographs taken by the undergraduates dental students in the paediatric dental clinic. Methods: The folder of 154 paediatric dental patient treated by the 4 th and 5 th year undergraduates dental students during the 2018/19 academic session were retrieved retrospectively from the record unit. The quality of the radiograph was graded as grade 1, grade 2 or grade 3 by two calibrated examiners based on the National Radiological Protection Board (NRPB) criteria. The justification and reporting of the radiographs were also assessed. Data were analysed using the Statistical Package for the Social Sciences (SPSS) Version 27 software (IBM, Armonk, NY, USA). Results: A total of 108 radiographs were available for assessment, which consist of 55 bitewings and 53 periapical radiographs. 6.5%, 45.4% and 48.2% of the radiographs taken were graded as grade 1, grade 2 and grade 3 respectively. The justification for radiographical investigation were stated in 88.9% of the radiographs, while only 11.1% did not justify. Investigating interproximal caries and periapical status of the teeth were the most common justification for taking bitewings and periapical radiographs respectively. Only 5.6% of the radiographic findings were reported either in the examination and diagnosis form or in the patients' folder, while the remaining 94.44% radiographs were not reported. Conclusion: Majority of the undergraduate dental students took poor quality radiographs which renders the radiograph to be diagnostically unacceptable and failed to record the reporting in the patient's folder. However, majority of the dental students did justify the needs for the radiographic investigation.

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