Incidence of osteoradionecrosis in patients who have undergone dental extraction prior to radiotherapy: A systematic review and meta-analysis

PurposeThis meta-analysis aimed to identify the incidence of osteoradionecrosis in patients who have undergone dental extraction prior to radiotherapy.MethodsA meta-analysis of observational studies of the incidence of osteoradionecrosis in patients who have undergone pre-radiotherapy dental extraction was conducted. Two reviewers searched the PubMed, Cochrane Library, ScienceDirect, and Embase databases to identify relevant studies. Pooled incidence estimates were calculated using a random-effects model. Meta-regression was conducted to identify factors associated with the incidence of osteoradionecrosis.ResultsEleven studies were included in the analyses. The incidence of osteoradionecrosis in the patients who underwent pre-radiotherapy dental extraction was 4.16% (95% confidence interval, 1.17–7.16%). Radiotherapy technology, radiation dose, and prophylactic antibiotic use did not significantly affect this incidence.ConclusionsThe incidence of osteoradionecrosis was very low. Future research should investigate the effects of mandibular radiation dose, dose fractionation, time interval of extraction, oral health status and drug risk factors on the incidence of osteoradionecrosis.