Retrospective study of association of dental extractions before radiotherapy and the risk of osteoradionecrosis in head and neck cancer patients

Patients with head and neck cancer undergo extraction of teeth with poor prognoses to minimize post-radiotherapy (RT) extractions, which are associated with risk of osteoradionecrosis (ORN). However, many patients are required to start RT before the extraction sites are completely healed. A retrospective study at Princess Margaret Cancer Centre (Toronto, Canada) investigated the association of timing of pre-RT dental extractions with risk of ORN. Among 879 patients, 16 patients (1.8%) developed ORN associated with pre-RT extractions. The average time interval between extraction and start of RT was 4.6 days shorter in patients with ORN than in patients without ORN. The authors conclude that although the timing of dental extractions affect ORN development, most extractions within 14 days of RT start date do not develop into ORN.