Lajolo Carlo, Rupe Cosimo, Gioco Gioele, Troiano Giuseppe, Patini Romeo, Petruzzi Massimo, Micciche' Francesco, Giuliani Michele
Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
School of Dentistry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Cancers (Basel). 2021 Nov 18;13(22):5798. doi: 10.3390/cancers13225798.
Teeth extractions before or after radiotherapy (RT) could be procedures at high risk for osteoradionecrosis (ORN) onset. This systematic review was performed to investigate the ORN incidence following teeth extractions during and after RT for head and neck (H&N) cancer and to evaluate any other possible risk factor.
This systematic review was conducted according to PRISMA protocol, and the PROSPERO registration number was CRD42018079986. An electronic search was performed on the following search engines: PubMed, Scopus, and Web of Science. A cumulative meta-analysis was performed.
Two thousand two hundred and eighty-one records were screened, and nine were finally included. This systematic review revealed an ORN incidence of 5.8% (41 patients out of 462, 95% CI = 2.3-9.4); 3 ORN developed in the maxilla. No other clinical risk factors were detected.
Post-RT teeth extractions represent a major risk factor for ORN development, especially in the mandible, with a diminishing trend in the last years. Further research on other possible risk factors might improve this evidence.
放疗（RT）前或放疗后拔牙可能是发生放射性骨坏死（ORN）的高风险操作。本系统评价旨在调查头颈部（H&N）癌放疗期间及放疗后拔牙后的ORN发生率，并评估任何其他可能的风险因素。
本系统评价按照PRISMA方案进行，PROSPERO注册号为CRD42018079986。在以下搜索引擎上进行电子检索：PubMed、Scopus和Web of Science。进行累积荟萃分析。
筛选了2281条记录，最终纳入9条。本系统评价显示ORN发生率为5.8%（462例中有41例，95%可信区间=2.3-9.4）；3例ORN发生在上颌骨。未检测到其他临床风险因素。
放疗后拔牙是ORN发生的主要风险因素，尤其是在下颌骨，近年来呈下降趋势。对其他可能风险因素的进一步研究可能会完善这一证据。
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