Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: A systematic review

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Abstract

This systematic review aims to identify and review the best available evidence to answer the clinical question 'What are the incidence and the factors influencing the development of osteoradionecrosis after tooth extraction in irradiated patients?'. A systematic review of published articles on post-irradiation extraction was performed via electronic search of the Medline, Ovid, Embase and Cochrane Library databases. Additional studies were identified by manual reference list search. Evaluation and critical appraisal were done in 3 stages by two independent reviewers and any disagreement was resolved by discussion with a third party. 19 articles were selected for the final analysis. The total incidence of osteoradionecrosis after tooth extraction in irradiated patients was 7%. When extractions were performed in conjunction with prophylactic hyperbaric oxygen, the incidence was 4% while extraction in conjunction with antibiotics gave an incidence of 6%. This systematic review found that while the incidence of osteoradionecrosis after post-irradiation tooth extractions is low, the extraction of mandibular teeth within the radiation field in patients who received a radiation dose higher than 60 Gy represents the highest risk of developing osteoradionecrosis. Based on weak evidence, prophylactic hyperbaric oxygen is effective in reducing the risk of developing osteoradionecrosis after post-radiation extractions.

Original languageEnglish
Pages (from-to)229-243
Number of pages15
JournalInternational Journal of Oral and Maxillofacial Surgery
Volume40
Issue number3
DOIs
Publication statusPublished - Mar 2011
Externally publishedYes

Fingerprint

Osteoradionecrosis
Tooth Extraction
Incidence
Radiation
Oxygen
Libraries
Databases
Anti-Bacterial Agents

Keywords

  • extraction
  • osteoradionecrosis
  • systematic review

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery

Cite this

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abstract = "This systematic review aims to identify and review the best available evidence to answer the clinical question 'What are the incidence and the factors influencing the development of osteoradionecrosis after tooth extraction in irradiated patients?'. A systematic review of published articles on post-irradiation extraction was performed via electronic search of the Medline, Ovid, Embase and Cochrane Library databases. Additional studies were identified by manual reference list search. Evaluation and critical appraisal were done in 3 stages by two independent reviewers and any disagreement was resolved by discussion with a third party. 19 articles were selected for the final analysis. The total incidence of osteoradionecrosis after tooth extraction in irradiated patients was 7{\%}. When extractions were performed in conjunction with prophylactic hyperbaric oxygen, the incidence was 4{\%} while extraction in conjunction with antibiotics gave an incidence of 6{\%}. This systematic review found that while the incidence of osteoradionecrosis after post-irradiation tooth extractions is low, the extraction of mandibular teeth within the radiation field in patients who received a radiation dose higher than 60 Gy represents the highest risk of developing osteoradionecrosis. Based on weak evidence, prophylactic hyperbaric oxygen is effective in reducing the risk of developing osteoradionecrosis after post-radiation extractions.",
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