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Oral and Maxillofacial Surgery

, Volume 20, Issue 4, pp 337–342 | Cite as

Cause and occurrence timing of osteoradionecrosis of the jaw: a retrospective study focusing on prophylactic tooth extraction

  • Satoshi Wanifuchi
  • Masaya Akashi
  • Yasuo Ejima
  • Hirotaka Shinomiya
  • Tsutomu Minamikawa
  • Shungo Furudoi
  • Naoki Otsuki
  • Ryohei Sasaki
  • Ken-ichi Nibu
  • Takahide Komori
Original Article

Abstract

Purpose

This retrospective study aimed to analyze the relationship between tooth extraction and osteoradionecrosis (ORN) occurrence. The irradiation field, dose, and time interval between radiotherapy (RT) and ORN were reviewed. We also discuss appropriate guidelines for prophylactic tooth extraction.

Methods

A total of 33 patients treated for grade ≥2 (clinical) ORN in our department from 2002 to 2014 were enrolled. The following epidemiological data were retrospectively gathered: age, sex, histological diagnosis, primary tumor sites, radiation dose, chemotherapy, site of ORN, relationship between tooth extraction and ORN occurrence, and time interval between tooth extraction and the initiation or end of RT.

Results

Twenty-one percent of ORN cases resulted from tooth extraction. The most common site of ORN (82 %) was the mandibular molar region. About half of ORN cases (49 %) occurred within 2 years after RT. All patients who received tooth extraction after RT developed ORN (100 %) independently of time interval between tooth extraction and the end of RT (median interval, 37.5 months; range, 27–120 months). In contrast, only 50 % of patients who received tooth extraction before RT developed ORN. There may have been an association between the irradiation field and the site of ORN development

Conclusions

ORN occurrence due to tooth extraction was 21 %. Occurrence timing of ORN did not depend on time interval between tooth extraction and the end of RT. The irradiation field is certainly related to the site of ORN; therefore, prophylactic tooth extraction should be performed in consideration of the proposed radiation field and dose.

Keywords

Head and neck malignancy Radiotherapy Osteoradionecrosis of the jaw Prophylactic tooth extraction 

Notes

Ethical approval

Not required.

Conflict of interest

The authors indicate full freedom of investigation and no potential gconflicts of interest.

Financial disclosure

There was no grant support for this study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Satoshi Wanifuchi
    • 1
  • Masaya Akashi
    • 1
  • Yasuo Ejima
    • 2
  • Hirotaka Shinomiya
    • 3
  • Tsutomu Minamikawa
    • 1
  • Shungo Furudoi
    • 1
  • Naoki Otsuki
    • 3
  • Ryohei Sasaki
    • 2
  • Ken-ichi Nibu
    • 3
  • Takahide Komori
    • 1
  1. 1.Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of Radiation OncologyKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of Otolaryngology-Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan

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