Osteoradionecrosis of the jaws

Widmark, Göran; Sagne, Sören; Heikel, P

doi:10.1016/s0901-5027(89)80100-6

“…Many authors of articles on ORN either failed to mention antibiotics at all, or made only a brief comment about their general application. 1,5,8,11,12,[28][29][30] The purpose of this investigation was to determine prescribing for exodontia and minor oral surgery following radiotherapy by surveying current opinion amongst consultant oral and maxillofacial surgeons.…”

Section: N B R I E Fmentioning

confidence: 99%

“…Although ORN can occur spontaneously, these procedures place the patient in great danger. 1 Predisposing factors for ORN include anatomic location of the tumour, total radiation dose, mode of radiation delivery and dental status. 9 Superimposed on the rate of developing ORN, extractions have been implicated more often than any other factor.…”

mentioning

confidence: 99%

A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity

Kanatas¹,

Rogers

²

,

Martin

³

2002

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Objectives To analyse the antibiotic prescribing trends for exodontia and minor oral surgery in patients with a history of radiotherapy. Also, to evaluate the use of hyperbaric oxygen as a separate modality in the prevention of osteoradionecrosis. Design A survey of antibiotic prescribing involving the analysis of a questionnaire which included the management of three patients with a history of head and neck malignancy. Method The heads of the departments in each unit in the UK were sent a closed-response questionnaire. Antibiotic prescribing was assessed in three case scenarios. Case one referred to a patient that had surgery alone as part of the management of head and neck cancer, who needed the surgical removal of second molar roots. Case two referred to a patient that had surgery and adjuvant radiotherapy as part of the management of head and neck cancer, and needed the same procedure as in case one. Case three included a patient with a history of surgery and adjuvant radiotherapy, who required the extraction of three mobile and periodontally-involved lower incisors. Consultants were also asked about the use of hyperbaric oxygen in the patients who had radiotherapy as part of their treatment strategy. Results A total of 109 questionnaires were sent to all the Maxillofacial Units in the UK. The response rate was 73%. In patients with a history of radical surgery alone for the management of head and neck cancer, 20% of the surgeons advocated pre-operative antibiotics for the surgical removal of lower posterior teeth. In contrast, in the patient with a history of adjuvant radiotherapy 86% supported pre-operative antimicrobial use for the surgical removal of the same teeth. In the extraction of mobile and periodontally involved lower incisors in the previously irradiated patient, 63% of the clinicians supported pre-extraction antibiotics. Postoperative antibiotics were advocated in 52% in the first case, 89% in the second case and 71% in the third case. 34% of the clinicians advocated hyperbaric oxygen for surgical removal of posterior teeth and 15% for the extraction of mobile anterior teeth.

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“…In the past, exposure of the maxilla and mandible to high-dose irradiation has been considered an essential contraindication for dental implantation (1). The risk of osteoradionecrosis, generally calculated to be about 5% after radiotherapy (4-6 MV photons), was assumed to be generally higher after dental implantation (2). In contrast, dental implantation following radiotherapy has been routinely carried out since 1985 in our department without major problems.…”

Section: Original Articlementioning

confidence: 99%

Osseointegration of Dental Implants in Patients with and without Radiotherapy

Wagner

¹

,

Eßer

²

,

Ostkamp

³

1998

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“…9 Superimposed on the rate of developing ORN, extractions have been implicated more often than any other factor. 1 ORN is more likely to arise after the removal of mandibular molars located directly in the treatment field. The chance of developing ORN after dental extraction ranges from 0 to 65%, but averages 5.8% when data from different studies are analysed.…”

mentioning

confidence: 99%

A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity

Kanatas¹,

Rogers

²

,

Martín

³

2002

View full text Add to dashboard Cite

Objectives To analyse the antibiotic prescribing trends for exodontia and minor oral surgery in patients with a history of radiotherapy. Also, to evaluate the use of hyperbaric oxygen as a separate modality in the prevention of osteoradionecrosis. Design A survey of antibiotic prescribing involving the analysis of a questionnaire which included the management of three patients with a history of head and neck malignancy. Method The heads of the departments in each unit in the UK were sent a closed-response questionnaire. Antibiotic prescribing was assessed in three case scenarios. Case one referred to a patient that had surgery alone as part of the management of head and neck cancer, who needed the surgical removal of second molar roots. Case two referred to a patient that had surgery and adjuvant radiotherapy as part of the management of head and neck cancer, and needed the same procedure as in case one. Case three included a patient with a history of surgery and adjuvant radiotherapy, who required the extraction of three mobile and periodontally-involved lower incisors. Consultants were also asked about the use of hyperbaric oxygen in the patients who had radiotherapy as part of their treatment strategy. Results A total of 109 questionnaires were sent to all the Maxillofacial Units in the UK. The response rate was 73%. In patients with a history of radical surgery alone for the management of head and neck cancer, 20% of the surgeons advocated pre-operative antibiotics for the surgical removal of lower posterior teeth. In contrast, in the patient with a history of adjuvant radiotherapy 86% supported pre-operative antimicrobial use for the surgical removal of the same teeth. In the extraction of mobile and periodontally involved lower incisors in the previously irradiated patient, 63% of the clinicians supported pre-extraction antibiotics. Postoperative antibiotics were advocated in 52% in the first case, 89% in the second case and 71% in the third case. 34% of the clinicians advocated hyperbaric oxygen for surgical removal of posterior teeth and 15% for the extraction of mobile anterior teeth.

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Osteoradionecrosis of the jaws

Cited by 68 publications

References 18 publications

A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity

A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity

Osseointegration of Dental Implants in Patients with and without Radiotherapy

A survey of antibiotic prescribing by maxillofacial consultants for dental extractions following radiotherapy to the oral cavity

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