Dental extractions in the irradiated head and neck patient; a retrospective analysis of Memorial Sloan-Kettering Cancer Center protocols, criteria and end results
- Sulaiman F, Huryn JM et al.
- Journal of oral and Maxillofacial Surgery
A conservative approach to dental extraction was accompanied by minimal osteoradionecrosis.
This study reviewed the treatment of 1194 irradiated head and neck tumor patients who had been evaluated and treated in the dental service of this large New York hospital. Most tumors were in the larynx, base of tongue, nasopharynx, parotid, oral tongue, floor of mouth and maxillary sinus. Three quarters were squamous cell carcinoma (SCC).
Dental extractions (two-thirds in posterior teeth) had been required in 187 patients aged 6 to 89 yrs. In about 10% of cases, antibiotics were given. Hyperbaric oxygen therapy (HBO) was given to 7 patients. Only 4 teeth were extracted during radiotherapy, but 300 were removed before, and 647 afterwards. More teeth were in the radiation field (528) than outside it (423).
Osteoradionecrosis developed in 4 patients who did not receive HBO. All 4 had SCC of the tongue or floor of the mouth. The authors discuss their protocols and procedures and advise conservative management of dental conditions in these patients.
Source: Sulaiman F, Huryn JM et al. J Oral Maxillofac Surg 2003; 61: 1123-1131