28 mainly retrospective studies were included in this review which aimed to determine if tooth extraction prior to head and neck radiotherapy (RT )is associated with a reduced risk of developing osteoradionectosis (ORN). The findings showed a significant association of post-RT dental extractions with the risk of ORN development, odds ratio = 1.98 (95%CI: 1.17 to 3.35. However the certainty of the evidence was low to moderate.
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This review of the osteoradionecrosis rate in patients with head and neck cancer having toothth extraction performed before radiotherapy included 8 mainly retrospective studies. The pooled incidence rate was estimated at 2.2% (95% CI: 0.6% to 3.9%) although none of the studies controlled for other risk factors.
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This review of whether the incidence of osteoradionecrosis differed between patients who have dental extractions before or after radiotherapy (RT) included 24 studies (19 retrospective 5 prospective). While the findings suggest that the incidence is similar if extractions are undertaken before or after RT the quality of the evidence is limited.
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This review assessing the evidence of the impact of replacing missing teeth with dentures on the development of osteoradionecrosis in patients who have radiotherapy for head and neck cancer only identified 3 case-controlled studies of very low quality.
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This Cochrane review of interventions for preventing osteoradionecrosis of the jaws in adults with head and neck cancer undergoing curative or adjuvant (i.e. non-palliative) radiotherapy included 4 RCTs. The limited quality of the available studies means evidence regarding the interventions evaluated in this review is uncertain.
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