To extract or not extract teeth prior to head and neck radiotherapy? A systematic review and meta-analysis

Autor(es):Mostrar menos -

Normando, Ana Gabriela Costa ; Perez-de-Oliveira, Maria Eduarda ; Silva Guerra, Eliete Neves ; Lopes, Marcio Ajudarte ; Rocha, Andre Caroli ; Brandao, Thais Bianca ; Prado-Ribeiro, Ana Carolina ; Monteiro Gueiros, Luiz Alcino ; Epstein, Joel B. ; Migliorati, Cesar Augusto ; Santos-Silva, Alan Roger ; Oral Care Study Grp ; Multinatl Assoc Supportive Care Ca ; Int Soc Oral Oncology ISOO

• Tipo de documento: Artigo Científico
• Fonte: SUPPORTIVE CARE IN CANCER; v. N/A, p. 15-pg., 2022-06-17.

Resumo

Purpose Teeth with poor prognosis are generally recommended to be extracted prior to head and neck radiotherapy (RT) to reduce the risk of developing osteoradionecrosis (ORN), although controversies have been reported. The present systematic review aimed to determine whether tooth extraction prior to head and neck RT may be associated with a reduced risk of developing ORN compared to dental extraction during or after RT. Methods The review protocol was registered in PROSPERO (CRD42021241631). The review was reported according to the PRISMA checklist and involved a comprehensive search of PubMed, Scopus, Embase, Cochrane Library, LILACS, and Web of Science, in addition to the gray literature. The selection of studies was performed in two phases by two reviewers independently. The risk of bias of individual studies was analyzed using the Joanna Briggs Institute checklist for cross-sectional studies, and the certainty of evidence was assessed using the GRADE tool. Results Twenty-eight observational studies were included in the qualitative synthesis, which showed substantial heterogeneity regarding the association between the timing of tooth extraction and ORN development. Twenty-seven of 28 studies were pooled in a meta-analysis that demonstrated a significant association between an increased risk of ORN and post-RT tooth extraction (odds ratio: 1.98; 95% CI: 1.17-3.35; p = 0.01). Conclusion It was confirmed with moderate certainty that dental extractions should be performed prior to the start of head and neck RT to reduce the risk of ORN. (AU)

• Processo FAPESP: 19/09692-9 - Validação de proteínas-alvo associadas à progressão de lesões potencialmente malignas para Câncer Oral
• Beneficiário: Ana Gabriela Costa Normando
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 19/26676-7 - Desvendando o papel da translocação CRTC1-MAML2 no Carcinoma Mucoepidermoide de glândula salivar: um estudo clínico-patológico, molecular e proteômico
• Beneficiário: Maria Eduarda Pérez de Oliveira
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 18/02233-6 - Segurança oncológica no uso da fotobiomodulação intraoral e extraoral em pacientes com carcinoma espinocelular de cavidade oral e orofaringe
• Beneficiário: Alan Roger dos Santos Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular