Dental extractions prior to radiotherapy to the jaws for reducing post-radiotherapy dental complications

Abstract

Dental extractions prior to radiotherapy to the jaws for reducing post-radiotherapy dental complications.

Dental extractions for preradiation dental clearance and incidence of osteoradionecrosis in patients with nasopharyngeal carcinoma treated with intensity‐modulated radiotherapy

“…and yet others consider extractions preradiation as a risk factor . However, much of these data are retrospective in nature, and a recent systematic review showed that there are currently no randomized, controlled trials to show that dental extractions preradiation will result in a lower incidence of ORN …”

Efficacy of a dental extraction policy designed to prevent osteoradionecrosis: a retrospective study in 100 oral cancer patients treated with intensity-modulated radiotherapy

“…These teeth were subsequently denoted as "not being considered a risk factor for ORN development after IMRT". Using the individual IMRT plans for each patient, all teeth (including those that were, and were not extracted) were subdivided according to maximum dose, with categories of < 50 Gy (1), 50 -60 Gy (2), and > 60 Gy (3). This distinction was made because there is still a risk of ORN, albeit reduced [2], even if the total radiation dose delivered by standard fractionation is below 60 Gy [1].…”

“…Furthermore, ORN lesions may occur spontaneously after radiotherapy, or after trauma, particularly after dental extractions [1]. Pre-treatment dental screens aim to reduce the risk of developing ORN following radiation therapy by removing teeth predicted to be at an increased risk of harboring infection or becoming infected [3].…”

A national survey of consultants, specialists and specialist registrars in restorative dentistry for the assessment and treatment planning of oral cancer patients

“…A recent Cochrane review on dental extractions before radiotherapy to the jaws for reducing post-radiotherapy dental complications highlighted that at present there are no randomised controlled trials to assess the effect of extracting teeth before radiotherapy compared to leaving teeth in the mouth during radiotherapy to the jaws. 52 All studies resulting from the search were either cohort studies or quality-of-life questionnaires. The review failed to support or refute the extraction or non-extraction of healthy or diseased teeth before radiotherapy for the reduction of subsequent dental complications.…”