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https://ptsldigital.ukm.my/jspui/handle/123456789/457443| Title: | Clinical and radiographic predictors of osteoradionecrosis post dental extraction among patients who received radiotherapy to the head & neck |
| Authors: | Khoo Szu Ching (P91340) |
| Supervisor: | Roszalina Ramli, Dr. |
| Keywords: | Radiography Dental Osteogenesis Universiti Kebangsaan Malaysia -- Dissertations Dissertations, Academic -- Malaysia |
| Issue Date: | 25-Aug-2020 |
| Description: | Osteoradionecrosis of the jawbones is a well-known complication of radiotherapy. Tooth extraction post radiotherapy is one of the most important risk factors of osteoradionecrosis. Besides clinical examination, imaging which is orthopantomogram helps with the osteoradionecrosis diagnosis. Tooth extraction post radiotherapy sometimes is inevitable. Osteoradionecrosis prevention is important by identifying the risk factors. To date, there is neither host factor nor pre-extraction radiographic finding being identified. This study was conducted to determine the association between these factors with osteoradionecrosis post extraction and to determine the predictors of osteoradionecrosis post extraction. This retrospective cross-sectional study analysed medical records and orthopantomogram data of patients with history of head and neck radiotherapy who had dental extraction performed from August 2005 to October 2019 from selected university hospitals in Kuala Lumpur, Malaysia. Data collection was performed from 1st July 2018 until 31st March 2020. Demographic, clinical data and radiographic findings were collected. 73 patients were included in this study. 16 (21.9%) had osteoradionecrosis post dental extraction. Of 389 teeth extracted, 33 sockets (8.5%) developed osteoradionecrosis. There was a significant association between tooth type, tooth pathology, surgical procedure, primary closure, radiation field, radiation dose and timing of extraction post radiotherapy with osteoradionecrosis. For radiographic factors, a significant association was observed between bony changes at extraction site and visibility of lower and upper cortical line of mandibular canal with osteoradionecrosis. Using multivariate analysis, the odds of developing an osteoradionecrosis from a surgical procedure was 6.50 (CI 1.37-30.91, p=0.02). For extraction more than five years after radiotherapy and upper cortical line of mandibular canal being invisible, the odds was 0.06 (CI 0.01-0.25, p<0.001) and 9.47 (CI 1.61-55.88, p=0.01), respectively. The new knowledge produced from this research was the invisibility of the upper cortical line of the mandibular canal. The findings from this research could guide the specialists and dental practitioners when doing post radiotherapy extraction. In conclusion, the prevalence of osteoradionecrosis following a dental extraction was 21.9% per subject and 8.27% per tooth. Extraction more than five years after radiotherapy, surgical removal procedure and the upper cortical line of mandibular canal being invisible were the predictors of osteoradionecrosis post extraction,Ijazah Doktor Pergigian Klinikal (Bedah Mulut dan Maksilofasial) |
| Pages: | 117 |
| Call Number: | WN230.K45c 2020 9 tesis |
| Publisher: | UKM, Kuala Lumpur |
| Appears in Collections: | Faculty of Dentistry / Fakulti Pergigian |
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| File | Description | Size | Format | |
|---|---|---|---|---|
| ukmvital_126423+Source01+Source010.PDF Restricted Access | 2.16 MB | Adobe PDF |  View/Open |
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