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17.06.2022 | Review Article

To extract or not extract teeth prior to head and neck radiotherapy? A systematic review and meta-analysis

verfasst von: Ana Gabriela Costa Normando, Maria Eduarda Pérez-de-Oliveira, Eliete Neves Silva Guerra, Márcio Ajudarte Lopes, André Caroli Rocha, Thaís Bianca Brandão, Ana Carolina Prado-Ribeiro, Luiz Alcino Monteiro Gueiros, Joel B. Epstein, César Augusto Migliorati, Alan Roger Santos-Silva, on behalf of the Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)

Erschienen in: Supportive Care in Cancer | Ausgabe 11/2022

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Abstract

Purpose

Teeth with poor prognosis are generally recommended to be extracted prior to head and neck radiotherapy (RT) to reduce the risk of developing osteoradionecrosis (ORN), although controversies have been reported. The present systematic review aimed to determine whether tooth extraction prior to head and neck RT may be associated with a reduced risk of developing ORN compared to dental extraction during or after RT.

Methods

The review protocol was registered in PROSPERO (CRD42021241631). The review was reported according to the PRISMA checklist and involved a comprehensive search of PubMed, Scopus, Embase, Cochrane Library, LILACS, and Web of Science, in addition to the gray literature. The selection of studies was performed in two phases by two reviewers independently. The risk of bias of individual studies was analyzed using the Joanna Briggs Institute checklist for cross-sectional studies, and the certainty of evidence was assessed using the GRADE tool.

Results

Twenty-eight observational studies were included in the qualitative synthesis, which showed substantial heterogeneity regarding the association between the timing of tooth extraction and ORN development. Twenty-seven of 28 studies were pooled in a meta-analysis that demonstrated a significant association between an increased risk of ORN and post-RT tooth extraction (odds ratio: 1.98; 95% CI: 1.17–3.35; p = 0.01).

Conclusion

It was confirmed with moderate certainty that dental extractions should be performed prior to the start of head and neck RT to reduce the risk of ORN.

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Titel: To extract or not extract teeth prior to head and neck radiotherapy? A systematic review and meta-analysis
verfasst von: Ana Gabriela Costa Normando
Maria Eduarda Pérez-de-Oliveira
Eliete Neves Silva Guerra
Márcio Ajudarte Lopes
André Caroli Rocha
Thaís Bianca Brandão
Ana Carolina Prado-Ribeiro
Luiz Alcino Monteiro Gueiros
Joel B. Epstein
César Augusto Migliorati
Alan Roger Santos-Silva
on behalf of the Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)
Publikationsdatum: 17.06.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 11/2022
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-022-07215-y

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To extract or not extract teeth prior to head and neck radiotherapy? A systematic review and meta-analysis