- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Dental extractions within 2 weeks of RT do not develop into osteoradionecrosis in head and neck cancer patients
Canada: A retrospective cohort study of 879 patients with head and neck cancer revealed an important association between the timing of pre-radiation therapy (RT) dental extractions and osteoradionecrosis (ORN) when extractions occurred within seven days of the RT start date.
Despite this, osteoradionecrosis after pre-RT extractions is relatively rare. The findings, published in JAMA Otolaryngology-Head & Neck Surgery, indicate that patients with head and neck cancer who are to undergo RT should not delay treatment for extractions when it might compromise oncologic control.
The researchers found those who healed had extractions an average of 4.8 days earlier than patients who developed ORN; however, only 1.8% (16 patients) developed ORN associated with pre-RT extractions.
Patients with head and neck cancer undergo teeth extraction with poor prognoses to minimize post-RT extractions, which are known to cause osteoradionecrosis. However, many patients are required to start RT before the complete healing of the extraction sites. The role of pre-RT extractions in ORN development has been disputed in the literature.
Against the above background, Junhyung Lee, Princess Margaret Cancer Centre, Toronto, Ontario, Canada, and colleagues aimed to investigate whether the timing of pre-RT dental extractions is associated with ORN development in patients with head and neck cancer.
For this purpose, the researchers conducted a retrospective cohort study at a single institution in Canada between 2011 and 2018. It included 879 patients with head and neck cancer who underwent pre-RT dental extractions before curative RT of 45 Gy or greater.
The investigators considered patient clinical characteristics and demographic information (eg, nodal involvement, primary cancer site, smoking status, chemotherapy, dental pathology).
The main outcomes of the study were timing (number of days) from dental extractions to RT start date and pre-RT extractions categorized as minor bone spicules (MBS), ORN, or healed.
The study led to the following findings:
- Of 879 patients with a median age of 62 years, 96.3% healed from pre-RT dental extractions, 1.8% developed MBS, and 1.8% developed ORN.
- The median time in number of days from pre-RT extraction(s) to the start of RT was 9 days in the healed cohort, 6 days in the MBS cohort, and 6 days in the ORN cohort.
- There was a large difference in the timing of pre-RT extractions between the healed and the MBS cohorts (mean 11.9 vs 7.4 days to radiation; difference 4.4), and the healed and the ORN cohorts (mean 11.9 vs 7.1 days; difference 4.8 days).
"These findings indicate that the timing of dental extractions affects ORN development, but most extractions performed within 14 days of the radiation therapy start date do not develop into ORN," the researchers concluded.
Reference:
Lee J, Hueniken K, Cuddy K, et al. Dental Extractions Before Radiation Therapy and the Risk of Osteoradionecrosis in Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. Published online October 19, 2023. doi:10.1001/jamaoto.2023.3429
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751