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.
The study aimed to quantify the impact of lockdown during the COVID-19 pandemic on new case referrals to the Oral and Maxillofacial Surgery (OMS) service. The researchers retrospectively reviewed all new referrals received during a government-imposed 47-day lockdown period and a similar period pre-lockdown as a control group. The main outcome was the differences in the number of new case referrals between the two periods. The contributing clinical and demographic factors were also explored. Appropriate bivariate statistics were computed and the level of significance was set at 0.05 for all tests. A total of 309 referrals were received during the study period. There was a reduction of new referrals due to the lockdown from five to two cases per day. There was a statistically significant reduction of cases referred from outpatient and emergency departments. There was also a statistically significant difference with regard to home address distance to the centre. Medically compromised and orofacial infection referrals were not affected by lockdown. The lockdown imposed due to the pandemic has significantly impacted the pattern of new OMS referrals. Referrals for orofacial infections, the medically compromised and inpatients were minimally affected by lockdown.
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