Agbaje Jimoh Olubanwo, Jacobs Reinhilde, Michiels Katleen, Abu-Ta'a Mahmoud, van Steenberghe Daniel
Oral Imaging Center, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium.
Clin Oral Investig. 2009 Sep;13(3):257-61. doi: 10.1007/s00784-008-0231-7. Epub 2008 Nov 5.
The aim of this study was to evaluate longitudinally the bone-healing process by measuring volumetric changes of the extraction sockets in head and neck cancer patients undergoing radiotherapy after tooth extraction. A total group of 15 patients (nine males, six females) undergoing tooth extraction at the Department of Periodontology (University Hospital KULeuven) were enrolled after giving informed consent. In seven patients, teeth presenting a risk for complications and eventual radionecrosis were extracted prior to the radiotherapeutical procedure. Monitoring of bone healing was performed by evaluating the volumetric changes of the alveoli by cone beam CT scanning (CBCT) at extraction and after 3 and 6 months. In parallel, a similar longitudinal evaluation of extraction sites was done in a control group of eight patients. Within this pilot-study, a total of 15 healing extraction sockets were evaluated and followed up. There was a significant difference in volumetric fill up of extraction sockets in test group vs. control group at three (37.1 +/- 7.9%) vs. (54.6 +/- 4.0%) and 6 months (47.2 +/- 8.8%) vs. (70.0 +/- 7.3%), respectively. The present pilot study demonstrated the clinical usefulness of CBCT for evaluation of extraction socket healing. The study objectively demonstrates the delayed bone healing after tooth extraction in irradiated head and neck cancer patients. Considering the limitations of this pilot study, a potential effect of radiotherapy on further jaw bone healing after pre-therapeutic tooth extractions should be further explored.
本研究的目的是通过测量头颈部癌症患者拔牙后接受放疗时拔牙窝的容积变化，纵向评估骨愈合过程。在获得知情同意后，招募了总共15例在牙周病科（鲁汶大学医院）拔牙的患者（9例男性，6例女性）。在7例患者中，在放疗程序之前拔除了存在并发症和最终放射性骨坏死风险的牙齿。通过在拔牙时以及3个月和6个月后用锥形束CT扫描（CBCT）评估牙槽的容积变化来监测骨愈合情况。同时，在一个由8例患者组成的对照组中对拔牙部位进行了类似的纵向评估。在这项初步研究中，总共评估并随访了15个愈合中的拔牙窝。试验组与对照组拔牙窝的容积填充在3个月时（分别为37.1±7.9% 对54.6±4.0%）和6个月时（分别为47.2±8.8% 对70.0±7.3%）存在显著差异。本初步研究证明了CBCT在评估拔牙窝愈合方面的临床实用性。该研究客观地证明了接受放疗的头颈部癌症患者拔牙后骨愈合延迟。考虑到这项初步研究的局限性，放疗对治疗前拔牙后颌骨进一步愈合的潜在影响应进一步探索。
