Abstract
Modern radiotherapy delivery systems and treatment strategies are aimed at limiting
the irradiation of healthy structures in the head and neck. This seeks to mitigate
post-treatment toxicities and complications such as osteoradionecrosis of the jaw.
Given the changes to radiotherapy, conventional workflows for the management of patients
requiring dentoalveolar surgery may no longer be suitable. It may therefore be appropriate
to revisit current treatment algorithms for the management of patients with radiotherapy
to the jaws who require dentoalveolar surgery. At present, there are poor data on
this. Development of a randomised trial may be warranted to establish the true relative
risk for extraction of teeth in the setting of modern radiation therapy delivery systems.
Keywords
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References
- Clinical controversies in oral and maxillofacial surgery: part two. Management of dental extractions in irradiated jaws: a protocol without hyperbaric oxygen therapy.J Oral Maxillofac Surg. 1997; 55: 275-281
- Dental extractions in the irradiated head and neck patient: a retrospective analysis of Memorial Sloan-Kettering Cancer Center protocols, criteria, and end results.J Oral Maxillofac Surg. 2003; 61: 1123-1131
- HOPON (Hyperbaric Oxygen for the Prevention of Osteoradionecrosis): a randomized controlled trial of hyperbaric oxygen to prevent osteoradionecrosis of the irradiated mandible after dentoalveolar surgery.Int J Radiat Oncol Biol Phys. 2019; 104: 530-539
- Radiographic osteoradionecrosis of the jaw with intact mucosa: proposal of clinical guidelines for early identification of this condition.Oral Oncol. 2015; 51: e93-6
Article info
Publication history
Published online: May 29, 2020
Accepted:
March 30,
2020
Received:
November 13,
2019
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
