Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Radiographic analysis of the management of tooth extractions in head and neck-irradiated patients: a case series

  • Oliveira, Samanta V. (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Vellei, Renata S. (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Heguedusch, Daniele (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Domaneschi, Carina (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Costa, Claudio (Stomatology Department, Universidade de Sao Paulo School of Dentistry) ;
  • Gallo, Camila de Barros (Stomatology Department, Universidade de Sao Paulo School of Dentistry)
  • Received : 2020.12.19
  • Accepted : 2021.02.05
  • Published : 2021.09.30
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Abstract

Tooth extraction after head and neck radiotherapy exposes patients to an increased risk for osteoradionecrosis of the jaw. This study reports the results of a radiographic analysis of bone neoformation after tooth extraction in a case series of patients who underwent radiation therapy. No patients developed osteoradionecrosis within a follow-up of 1 year. Complete mucosal repair was observed 30 days after surgery, while no sign of bone formation was observed 2 months after the dental extractions. Pixel intensity and fractal dimension image analyses only showed significant bone formation 12 months after the tooth extractions. These surgical procedures must follow a strict protocol that includes antibiotic prophylaxis and therapy and complete wound closure, since bone formation at the alveolar socket occurs at a slower pace in patients who have undergone head and neck radiotherapy.

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Acknowledgement

The authors would like to thank the Interdisciplinary Academic League of Oral Cancer(Liga Interdisciplinar das Neoplasias Bucais - LINB) and the funding agencies Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES - Brazilian Government) and Programa Unificado de Bolsas de Estudos para Apoio e Formacao de Estudantes de Graduacao (PUB-Universidade de Sao Paulo USP) for the scholarships(Samanta Vicente Oliveira and Renata dos Santos Vellei). Finally, we would like to thank Solange Kobayashi-Velasco for the English grammar and style review.

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