Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis
Background/purpose: Osteoradionecrosis of the jaw (ORN) often occurs in patients with head and neck cancer undergoing radiotherapy (RT). It has been recommended to extract the tooth before RT that may become source of infection, but in recent years, some investigators have reported that tooth extrac...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | Journal of Dental Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1991790221002671 |
| _version_ | 1818365439798935552 |
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| author | Yuka Kojima Mitsunobu Otsuru Takumi Hasegawa Nobuhiro Ueda Tadaaki Kirita Shin-ichi Yamada Hiroshi Kurita Yasuyuki Shibuya Madoka Funahara Masahiro Umeda |
| author_facet | Yuka Kojima Mitsunobu Otsuru Takumi Hasegawa Nobuhiro Ueda Tadaaki Kirita Shin-ichi Yamada Hiroshi Kurita Yasuyuki Shibuya Madoka Funahara Masahiro Umeda |
| author_sort | Yuka Kojima |
| collection | DOAJ |
| description | Background/purpose: Osteoradionecrosis of the jaw (ORN) often occurs in patients with head and neck cancer undergoing radiotherapy (RT). It has been recommended to extract the tooth before RT that may become source of infection, but in recent years, some investigators have reported that tooth extraction before RT increase the risk of developing ORN and therefore should be avoided. The purpose of the study is to evaluate the risk factors for ORN including tooth extraction before RT. Materials and methods: This was a retrospective study of 366 patients with oral or oropharyngeal cancer who underwent RT of 50 Gy or more at six university hospitals, with follow-up of at least six months post-RT. The relationship between each factor and ORN incidence was analyzed using the Cox proportional hazard model. Results: Periapical lesions, more than 50% loss of alveolar bone, and tooth extraction after RT significantly correlated with ORN. Intensity-modulated RT showed a lower incidence than three-dimensional conformal RT, although not statistically different. Tooth extraction before RT significantly reduced ORN incidence, after adjusting the background factors using propensity score matching. Conclusion: In patients with oral or oropharyngeal cancer who underwent RT, periapical lesions, more than 50% loss of alveolar bone, and tooth extraction after RT significantly increased the risk for ORN. Infected tooth extraction before RT significantly reduced the risk. |
| first_indexed | 2024-12-13T22:20:17Z |
| format | Article |
| id | doaj.art-61a9c03c85e94172be0152d61a19f1b3 |
| institution | Directory Open Access Journal |
| issn | 1991-7902 |
| language | English |
| last_indexed | 2024-12-13T22:20:17Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Dental Sciences |
| spelling | doaj.art-61a9c03c85e94172be0152d61a19f1b32022-12-21T23:29:24ZengElsevierJournal of Dental Sciences1991-79022022-04-0117210241029Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysisYuka Kojima0Mitsunobu Otsuru1Takumi Hasegawa2Nobuhiro Ueda3Tadaaki Kirita4Shin-ichi Yamada5Hiroshi Kurita6Yasuyuki Shibuya7Madoka Funahara8Masahiro Umeda9Department of Dentistry and Oral Surgery, Kansai Medical University, Hirakata, Japan; Corresponding author. Department of Dentistry and Oral Surgery, Kansai Medical University 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan. Fax: +81 72 804 2983Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, JapanDepartment of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, JapanDepartment of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, JapanDepartment of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, JapanDepartment of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, JapanDepartment of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanKyushu Dental University School of Oral Health, Kitakyushu, JapanDepartment of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanBackground/purpose: Osteoradionecrosis of the jaw (ORN) often occurs in patients with head and neck cancer undergoing radiotherapy (RT). It has been recommended to extract the tooth before RT that may become source of infection, but in recent years, some investigators have reported that tooth extraction before RT increase the risk of developing ORN and therefore should be avoided. The purpose of the study is to evaluate the risk factors for ORN including tooth extraction before RT. Materials and methods: This was a retrospective study of 366 patients with oral or oropharyngeal cancer who underwent RT of 50 Gy or more at six university hospitals, with follow-up of at least six months post-RT. The relationship between each factor and ORN incidence was analyzed using the Cox proportional hazard model. Results: Periapical lesions, more than 50% loss of alveolar bone, and tooth extraction after RT significantly correlated with ORN. Intensity-modulated RT showed a lower incidence than three-dimensional conformal RT, although not statistically different. Tooth extraction before RT significantly reduced ORN incidence, after adjusting the background factors using propensity score matching. Conclusion: In patients with oral or oropharyngeal cancer who underwent RT, periapical lesions, more than 50% loss of alveolar bone, and tooth extraction after RT significantly increased the risk for ORN. Infected tooth extraction before RT significantly reduced the risk.http://www.sciencedirect.com/science/article/pii/S1991790221002671RadiotherapyOral or oropharyngeal cancerOsteoradionecrosisRisk factorTooth extraction |
| spellingShingle | Yuka Kojima Mitsunobu Otsuru Takumi Hasegawa Nobuhiro Ueda Tadaaki Kirita Shin-ichi Yamada Hiroshi Kurita Yasuyuki Shibuya Madoka Funahara Masahiro Umeda Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis Journal of Dental Sciences Radiotherapy Oral or oropharyngeal cancer Osteoradionecrosis Risk factor Tooth extraction |
| title | Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis |
| title_full | Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis |
| title_fullStr | Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis |
| title_full_unstemmed | Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis |
| title_short | Risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer: Verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis |
| title_sort | risk factors for osteoradionecrosis of the jaw in patients with oral or oropharyngeal cancer verification of the effect of tooth extraction before radiotherapy using propensity score matching analysis |
| topic | Radiotherapy Oral or oropharyngeal cancer Osteoradionecrosis Risk factor Tooth extraction |
| url | http://www.sciencedirect.com/science/article/pii/S1991790221002671 |
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