DOI QR코드

DOI QR Code

Radiographic analysis of the management of tooth extractions in head and neck-irradiated patients: a case series

  • Oliveira, Samanta V. (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Vellei, Renata S. (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Heguedusch, Daniele (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Domaneschi, Carina (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Costa, Claudio (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Gallo, Camila de Barros (Stomatology Department, Universidade de Sao Paulo School of Dentistry)
  • 투고 : 2020.12.19
  • 심사 : 2021.02.05
  • 발행 : 2021.09.30

초록

Tooth extraction after head and neck radiotherapy exposes patients to an increased risk for osteoradionecrosis of the jaw. This study reports the results of a radiographic analysis of bone neoformation after tooth extraction in a case series of patients who underwent radiation therapy. No patients developed osteoradionecrosis within a follow-up of 1 year. Complete mucosal repair was observed 30 days after surgery, while no sign of bone formation was observed 2 months after the dental extractions. Pixel intensity and fractal dimension image analyses only showed significant bone formation 12 months after the tooth extractions. These surgical procedures must follow a strict protocol that includes antibiotic prophylaxis and therapy and complete wound closure, since bone formation at the alveolar socket occurs at a slower pace in patients who have undergone head and neck radiotherapy.

키워드

과제정보

The authors would like to thank the Interdisciplinary Academic League of Oral Cancer(Liga Interdisciplinar das Neoplasias Bucais - LINB) and the funding agencies Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES - Brazilian Government) and Programa Unificado de Bolsas de Estudos para Apoio e Formacao de Estudantes de Graduacao (PUB-Universidade de Sao Paulo USP) for the scholarships(Samanta Vicente Oliveira and Renata dos Santos Vellei). Finally, we would like to thank Solange Kobayashi-Velasco for the English grammar and style review.

참고문헌

  1. Chronopoulos A, Zarra T, Ehrenfeld M, Otto S. Osteoradionecrosis of the jaws: definition, epidemiology, staging and clinical and radiological findings. A concise review. Int Dent J 2018; 68: 22-30. https://doi.org/10.1111/idj.12318
  2. Nabil S, Samman N. Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review. Int J Oral Maxillofac Surg 2011; 40: 229-43. https://doi.org/10.1016/j.ijom.2010.10.005
  3. Notani K, Yamazaki Y, Kitada H, Sakakibara N, Fukuda H, Omori K, et al. Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radiotherapy. Head Neck 2003; 25: 181-6. https://doi.org/10.1002/hed.10171
  4. Chan KC, Perschbacher SE, Lam EW, Hope AJ, McNiven A, Atenafu EG, et al. Mandibular changes on panoramic imaging after head and neck radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121: 666-72. https://doi.org/10.1016/j.oooo.2016.01.023
  5. Khojastepour L, Bronoosh P, Zeinalzade M. Mandibular bone changes induced by head and neck radiotherapy. Indian J Dent Res 2012; 23: 774-7. https://doi.org/10.4103/0970-9290.111258
  6. Palma LF, Tateno RY, Remondes CM, Marcucci M, Cortes AR. Impact of radiotherapy on mandibular bone: a retrospective study of digital panoramic radiographs. Imaging Sci Dent 2020; 50: 31-6. https://doi.org/10.5624/isd.2020.50.1.31
  7. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 628-35. https://doi.org/10.1016/S1079-2104(99)70097-1
  8. Beech NM, Porceddu S, Batstone MD. Radiotherapy-associated dental extractions and osteoradionecrosis. Head Neck 2017; 39: 128-32. https://doi.org/10.1002/hed.24553
  9. Kuo TJ, Leung CM, Chang HS, Wu CN, Chen WL, Chen GJ, et al. Jaw osteoradionecrosis and dental extraction after head and neck radiotherapy: a nationwide population-based retrospective study in Taiwan. Oral Oncol 2016; 56: 71-7. https://doi.org/10.1016/j.oraloncology.2016.03.005
  10. Jawad H, Hodson NA, Nixon PJ. A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 2. Br Dent J 2015; 218: 69-74. https://doi.org/10.1038/sj.bdj.2015.29
  11. Morais-Faria K, Menegussi G, Marta G, Fernandes PM, Dias RB, Ribeiro AC, et al. Dosimetric distribution to the teeth of patients with head and neck cancer who underwent radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120: 416-9. https://doi.org/10.1016/j.oooo.2015.05.009
  12. Marx RE, Johnson RP. Studies in the radiobiology of osteoradionecrosis and their clinical significance. Oral Surg Oral Med Oral Pathol 1987; 64: 379-90. https://doi.org/10.1016/0030-4220(87)90136-8
  13. Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants. J Clin Periodontol 2014; 41 Suppl 15: S6-22. https://doi.org/10.1111/jcpe.12206
  14. Kimura-Fujikami T, Cabrera-Munoz ML, Del Valle-Espinoza A. Laser therapy in orthognathic surgery. Gac Med Mex 2005; 141: 27-33.
  15. Abd-Elaal AZ, El-Mekawii HA, Saafan AM, El Gawad LA, El-Hawary YM, Abdelrazik MA. Evaluation of the effect of low-level diode laser therapy applied during the bone consolidation period following mandibular distraction osteogenesis in the human. Int J Oral Maxillofac Surg 2015; 44: 989-97. https://doi.org/10.1016/j.ijom.2015.04.010
  16. Refai H, Radwan D, Hassanien N. Radiodensitometric assessment of the effect of pulsed electromagnetic field stimulation versus low intensity laser irradiation on mandibular fracture repair: a preliminary clinical trial. J Maxillofac Oral Surg 2014; 13: 451-7. https://doi.org/10.1007/s12663-013-0551-2
  17. Metin R, Tatli U, Evlice B. Effects of low-level laser therapy on soft and hard tissue healing after endodontic surgery. Lasers Med Sci 2018; 33: 1699-706. https://doi.org/10.1007/s10103-018-2523-8
  18. Mikhail FF, El-Din M, Ibrahim T, Zekry K, Nemat A, Nasry S. Effect of laser therapy on the osseointegration of immediately loaded dental implants in patients under vitamin C, omega-3 and calcium therapy. Open Access Maced J Med Sci 2018; 6: 1468-74. https://doi.org/10.3889/oamjms.2018.291
  19. Da Cunha SS, Sarmento V, Ramalho LM, De Almeida D, Veeck EB, Da Costa NP, et al. Effect of laser therapy on bone tissue submitted to radiotherapy: experimental study in rats. Photomed Laser Surg 2007; 25: 197-204. https://doi.org/10.1089/pho.2007.2002
  20. Freire MR, Almeida D, Santos JN, Sarmento VA. Evaluation of bone repair after radiotherapy by photobiomodulation - an animal experimental study. Laser Phys 2011; 21: 958. https://doi.org/10.1134/S1054660X11070085
  21. Korany NS, Mehanni SS, Hakam HM, El-Maghraby EM. Evaluation of socket healing in irradiated rats after diode laser exposure (histological and morphometric studies). Arch Oral Biol 2012; 57: 884-91. https://doi.org/10.1016/j.archoralbio.2012.01.009
  22. El-Maghraby EM, El-Rouby DH, Saafan AM. Assessment of the effect of low-energy diode laser irradiation on gamma irradiated rats' mandibles. Arch Oral Biol 2013; 58: 796-805. https://doi.org/10.1016/j.archoralbio.2012.10.003
  23. Maman Fracher Abramoff M, Pereira MD, de Seixas Alves MT, Segreto RA, Guilherme A, Ferreira LM. Low-level laser therapy on bone repair of rat tibiae exposed to ionizing radiation. Photomed Laser Surg 2014; 32: 618-26. https://doi.org/10.1089/pho.2013.3692
  24. Batista JD, Zanetta-Barbosa D, Cardoso SV, Dechichi P, Rocha FS, Pagnoncelli RM. Effect of low-level laser therapy on repair of the bone compromised by radiotherapy. Lasers Med Sci 2014; 29: 1913-8. https://doi.org/10.1007/s10103-014-1602-8
  25. Zhang WB, Zheng LW, Chua D, Cheung LK. Bone regeneration after radiotherapy in an animal model. J Oral Maxillofac Surg 2010; 68: 2802-9. https://doi.org/10.1016/j.joms.2010.04.024