This review of the effectiveness of sodium bicarbonate in the prevention and management of oral mucositis included 11 RCTs. The included studies were small, hetrogeneous and suggested little benefit from the use of sodium bicoarbonate mouthwashes.
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This review assessing the effect of radiotherapy on the survival of dental implants in patients with head and neck cancer included 7 studies involving a total of 441 patients. implant survival rate was lower in irradiated patients with odds ratio = 4.77 (95%CI; 2.57 to 8.89) based on 4 studies.
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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 whether chemotherapy, in addition to radiotherapy and/or surgery for oral cavity and oropharyngeal cancer, results in improved overall survival included 100 studies. the findings indicated some benefit only when used in a few specific circumstances.
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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 assessing the effectiveness of intraoral stents in reducing toxicities in oral cavity induced by radiotherapy in head and neck region included 7 small studies. While the analysis suggests a beneficial effect from the use of intraoral stents the included studies only provide verylow certainty evidence so further high-quality RCTs are needed.
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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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Manas Dave takes a look at this review evaluating the prophylactic and therapeutic effects of low-level laser therapy (LLLT) in patients who might or have developed oral mucositis during chemotherapy or radiotherapy.
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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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