Non-Cochrane · prognostic · PM42500079
Timing for Radiotherapy Initiation After Dental Extraction and Risk of Osteoradionecrosis in Head and Neck Cancer Patients: A Systematic Review and Meta-Analysis.
Liu Nuo-Zhou, Liu Yi-Xuan, Li Zhe, et al. · World journal of otorhinolaryngology - head and neck surgery · 2026 · PubMed · doi:10.1002/wjo2.70097
Findings
Population Head and neck cancer patients undergoing pre-radiotherapy dental extraction
10 findings
| Radiotherapy initiated 14 days or less after dental extraction | Radiotherapy initiated more than 14 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Western populations, random-effects model | OR 2.01 [0.79, 5.08] GRADE not reported 3 studies · 1445 participants |
| Radiotherapy initiated 14 days or less after dental extraction | Radiotherapy initiated more than 14 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Overall (all populations) | OR 0.99 [0.67, 1.47] GRADE not reported 8 studies · 47527 participants |
| Radiotherapy initiated 14 days or less after dental extraction | Radiotherapy initiated more than 14 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Asian populations, random-effects model | OR 0.85 [0.56, 1.28] GRADE not reported 5 studies · 32036 participants |
| Radiotherapy initiated 14 days or less after dental extraction | Radiotherapy initiated more than 14 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Overall (all populations), common-effect model | OR 1.11 [1.03, 1.20] GRADE not reported 8 studies · 47527 participants |
| Radiotherapy initiated 14 days or less after dental extraction | Radiotherapy initiated more than 14 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Asian populations | OR 1.10 [1.01, 1.19] GRADE not reported 5 studies · 32036 participants |
| Radiotherapy initiated 14 days or less after dental extraction | Radiotherapy initiated more than 14 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Western populations | OR 2.01 [1.10, 3.68] GRADE not reported 3 studies · 1445 participants |
| Radiotherapy initiated 7 days or less after dental extraction | Radiotherapy initiated more than 7 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Western populations, random-effects model | OR 3.06 [1.52, 6.20] GRADE not reported 2 studies · 908 participants |
| Radiotherapy initiated 7 days or less after dental extraction | Radiotherapy initiated more than 7 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Overall (all populations), random-effects model | OR 1.58 [0.50, 5.01] GRADE not reported 3 studies · 5970 participants |
| Radiotherapy initiated 7 days or less after dental extraction | Radiotherapy initiated more than 7 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Western populations | OR 3.07 [1.52, 6.21] GRADE not reported 2 studies · 908 participants |
| Radiotherapy initiated 7 days or less after dental extraction | Radiotherapy initiated more than 7 days after dental extraction | Osteoradionecrosis (ORN) Interval between last dental extraction and RT initiation · Overall (all populations), common-effect model | OR 1.33 [0.86, 2.06] GRADE not reported 3 studies · 5970 participants |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Liao 2020 Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan DOI:10.1111/coa.13624 | 2020 | 1 other review | not stated | not extracted yet |
| Chang 2022 The impact of dental therapy timelines and irradiation dosages on osteoradionecrosis in oral cancer patients: A population-based cohort… DOI:10.1016/j.oraloncology.2022.105827 | 2022 | this review only | not stated | not extracted yet |
| Chang 2022 The impact of dental therapy timelines and irradiation dosages on osteoradionecrosis in oral cancer patients: A population-based cohort… PMID:35364549 | 2022 | this review only | not stated | not extracted yet |
| Huang 2020 The association between dental therapy timelines and osteoradionecrosis: a nationwide population-based cohort study DOI:10.1007/s00784-019-02866-4 | 2019 | this review only | not stated | not extracted yet |
| Huang 2020 The association between dental therapy timelines and osteoradionecrosis: a nationwide population-based cohort study. PMID:31111283 | 2020 | this review only | not stated | not extracted yet |
| Kovarik 2022 Osteoradionecrosis after treatment of head and neck cancer: a comprehensive analysis of risk factors with a particular focus on role of… DOI:10.1016/j.bjoms.2021.03.009 | 2022 | this review only | not stated | not extracted yet |
| Kovarik 2022 Osteoradionecrosis after treatment of head and neck cancer: a comprehensive analysis of risk factors with a particular focus on role of… PMID:34857411 | 2022 | this review only | not stated | not extracted yet |
| Lee 2023 Dental Extractions Before Radiation Therapy and the Risk of Osteoradionecrosis in Patients With Head and Neck Cancer DOI:10.1001/jamaoto.2023.3429 | 2023 | this review only | not stated | not extracted yet |
| Lee 2023 Dental Extractions Before Radiation Therapy and the Risk of Osteoradionecrosis in Patients With Head and Neck Cancer. PMID:37856115 | 2023 | this review only | not stated | not extracted yet |
| Liao 2020 Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population-based retrospective study in Taiwan. PMID:32738824 | 2020 | this review only | not stated | not extracted yet |
| Shih 2024 Tooth extraction within 2 weeks before radiotherapy and osteoradionecrosis: A nationwide cohort study DOI:10.1111/odi.14349 | 2022 | this review only | not stated | not extracted yet |
| Shih 2024 Tooth extraction within 2 weeks before radiotherapy and osteoradionecrosis: A nationwide cohort study. PMID:35951468 | 2024 | this review only | not stated | not extracted yet |
| Starcke 1977 How critical is the interval between extractions and irradiation in patients with head and neck malignancy? DOI:10.1016/0030-4220(77)90317-6 | 1977 | this review only | not stated | not extracted yet |
| Starcke 1977 How critical is the interval between extractions and irradiation in patients with head and neck malignancy? PMID:265036 | 1977 | this review only | not stated | not extracted yet |
| Wang 2017 Risk factors for and the role of dental extractions in osteoradionecrosis of the jaws: A national‐based cohort study DOI:10.1002/hed.24761 | 2017 | this review only | not stated | not extracted yet |
| Wang 2017 Risk factors for and the role of dental extractions in osteoradionecrosis of the jaws: A national-based cohort study. PMID:28370713 | 2017 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Identifying risk factors for osteoradionecrosis of the jaws: a systematic review and meta-analysis. (2026) | 1 | 0.02 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Head and neck cancer patients undergoing dental extraction before, during or after radiotherapy | Head and neck cancer patients with pre-RT dental extraction (n=47527; 2863 ORN cases) |
| Intervention | Shorter interval between dental extraction and RT initiation (<=7 days; <=14 days) | RT initiated <=7 days or <=14 days after extraction |
| Comparison | Longer interval (>7 days; >14 days) | RT initiated >7 days or >14 days after extraction |
| Outcomes | Osteoradionecrosis incidence | Osteoradionecrosis (n=8 studies) |
| Study designs | RCTs and observational studies (cross-sectional, case-control, cohort) | Retrospective cohort studies (n=8) |
| Timing | Not specified | Not specified |