Non-Cochrane · aetiology · PM42631744
Identifying risk factors for osteoradionecrosis of the jaws: a systematic review and meta-analysis.
de Carli Rafaella Luiza Bergamaschi, Marega Naiara Alves, de Oliveira Analú Barros, et al. · Clinical oral investigations · 2026 · PubMed · doi:10.1007/s00784-026-07077-2
Findings
Population Patients with head and neck cancer treated with radiotherapy
63 findings
| Oral cavity cancer (tumor site) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 4 [2.9, 5.51] Moderate Downgraded: risk of bias, inconsistency 4 studies · 6872 participants |
| Oral cancer (oral cavity tumor site) | No oral cancer (other tumor sites) | Development of osteoradionecrosis of the jaws (ORNJ) Trim-and-fill sensitivity analysis | OR 4.81 [1.56, 14.9] GRADE not reported 4 studies · 6872 participants |
| Oral cavity cancer (tumor site) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 4.81 [1.56, 14.9] GRADE not reported 4 studies · 6872 participants |
| Tonsillar region tumor (tumor site) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.32 [0.87, 2.01] GRADE not reported 2 studies · 1430 participants |
| Tumor located in the tonsillar region | Tumor not in the tonsillar region | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | OR 1.32 [0.87, 2.01] Moderate Downgraded: risk of bias, imprecision 2 studies · 1430 participants |
| Tumor located at the base of the tongue | Tumor not at the base of the tongue | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | OR 0.75 [0.48, 1.18] Moderate Downgraded: risk of bias, imprecision 2 studies · 1430 participants |
| Base of tongue tumor (tumor site) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.75 [0.48, 1.18] GRADE not reported 2 studies · 1430 participants |
| Oropharyngeal tumor (tumor site) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 2.34 [1.63, 3.34] Moderate Downgraded: risk of bias 3 studies · 1810 participants |
| Oropharyngeal tumor | Non-oropharyngeal tumor | Development of osteoradionecrosis of the jaws (ORNJ) Trim-and-fill sensitivity analysis | OR 2.61 [0.32, 21.52] GRADE not reported 3 studies · 1810 participants |
| Oropharyngeal tumor (tumor site) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 2.61 [0.32, 21.52] GRADE not reported 3 studies · 1810 participants |
| Diabetes mellitus | No diabetes mellitus | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | OR 1.01 [0.86, 1.19] Moderate Downgraded: risk of bias 7 studies · 23068 participants |
| Diabetes mellitus (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.01 [0.86, 1.19] GRADE not reported 7 studies · 23068 participants |
| Diabetes mellitus | No diabetes mellitus | Development of osteoradionecrosis of the jaws (ORNJ) Trim-and-fill sensitivity analysis | OR 1.01 [0.86, 1.19] GRADE not reported 7 studies · 23068 participants |
| Neck dissection (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.47 [0.88, 2.45] Low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 1430 participants |
| Neck dissection (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.39 [0.58, 3.33] GRADE not reported 2 studies · 1430 participants |
| T1 tumor stage | Other T stages | Development of osteoradionecrosis of the jaws (ORNJ) Trim-and-fill sensitivity analysis | OR 2.44 [0.12, 48.28] GRADE not reported 4 studies · 2825 participants |
| T1 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 2.44 [0.12, 48.28] GRADE not reported 4 studies · 2825 participants |
| T1 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.01 [0.62, 1.65] Low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 2825 participants |
| T2 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.78 [1.32, 2.41] Low Downgraded: risk of bias, imprecision, inconsistency, publication bias 4 studies · 2825 participants |
| T2 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 2.9 [0.71, 11.81] GRADE not reported 4 studies · 2996 participants |
| T2 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 2.05 [0.42, 9.98] GRADE not reported 4 studies · 2825 participants |
| T1-T2 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.89 [0.47, 1.7] GRADE not reported 2 studies · 481 participants |
| T1-T2 tumor stage | T3-T4 tumor stage | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | OR 0.89 [0.46, 1.7] Moderate Downgraded: risk of bias, imprecision 2 studies · 481 participants |
| T3 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.3 [0.91, 1.86] Low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 2825 participants |
| T3 tumor stage | Other T stages | Development of osteoradionecrosis of the jaws (ORNJ) Trim-and-fill sensitivity analysis | OR 1.98 [0.44, 8.81] GRADE not reported 4 studies · 2825 participants |
| T3 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.98 [0.44, 8.81] GRADE not reported 4 studies · 2825 participants |
| T4 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 1.75 [0.69, 4.45] GRADE not reported 4 studies · 4049 participants |
| T4 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.98 [1.38, 2.84] Low Downgraded: risk of bias, imprecision, inconsistency, publication bias 4 studies · 2825 participants |
| T4 tumor stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 2.44 [1.08, 5.51] GRADE not reported 4 studies · 2825 participants |
| N0 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 1.73 [0.73, 4.08] GRADE not reported 3 studies · 2006 participants |
| N0 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.01 [0.66, 1.54] Low Downgraded: risk of bias, imprecision, inconsistency, publication bias 3 studies · 1601 participants |
| N0 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.97 [0.45, 2.09] GRADE not reported 3 studies · 1601 participants |
| N1 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.2 [0.74, 1.96] GRADE not reported 3 studies · 1601 participants |
| N1 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.19 [0.74, 1.92] Moderate Downgraded: risk of bias, publication bias 3 studies · 1601 participants |
| N1 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 1.51 [1.02, 2.26] GRADE not reported 3 studies · 3031 participants |
| N2 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | RR 1.03 [0.82, 1.3] GRADE not reported 3 studies · 1601 participants |
| N2 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | RR 1.01 [0.87, 1.17] Moderate Downgraded: risk of bias, publication bias 3 studies · 1601 participants |
| N2 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | RR 0.9 [0.71, 1.15] GRADE not reported 3 studies · 2006 participants |
| N2a nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.72 [0.17, 3.06] GRADE not reported 2 studies · 1430 participants |
| N2a nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 0.58 [0.24, 1.41] Moderate Downgraded: risk of bias, imprecision 2 studies · 1430 participants |
| N2b nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | RR 0.89 [0.65, 1.2] GRADE not reported 2 studies · 1430 participants |
| N2b nodal stage | Other N stages | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | RR 0.89 [0.65, 1.2] Moderate Downgraded: risk of bias, imprecision 2 studies · 1430 participants |
| N2c nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.15 [0.73, 1.82] GRADE not reported 2 studies · 1430 participants |
| N2c nodal stage | Other N stages | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | OR 1.15 [0.73, 1.82] Moderate Downgraded: risk of bias, imprecision 2 studies · 1430 participants |
| N3 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 1.02 [0.41, 2.55] GRADE not reported 3 studies · 2006 participants |
| N3 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.57 [0.25, 1.34] GRADE not reported 3 studies · 1601 participants |
| N3 nodal stage (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 0.6 [0.31, 1.19] Moderate Downgraded: risk of bias, publication bias 3 studies · 1601 participants |
| Good oral hygiene (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.39 [0.21, 0.76] GRADE not reported 2 studies · 337 participants |
| Good oral hygiene | Poor or fair oral hygiene | Development of osteoradionecrosis of the jaws (ORNJ) Common-effect model (primary analysis) | OR 0.4 [0.21, 0.76] Moderate Downgraded: risk of bias, imprecision 2 studies · 337 participants |
| Chemotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 1.42 [0.47, 4.29] GRADE not reported 7 studies · 24677 participants |
| Chemotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 0.72 [0.19, 2.72] GRADE not reported 7 studies · 26135 participants |
| Chemotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 0.84 [0.74, 0.94] Low Downgraded: imprecision, inconsistency, publication bias 7 studies · 24677 participants |
| Tobacco use (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 2.18 [0.73, 6.49] GRADE not reported 7 studies · 3422 participants |
| Tobacco use (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 3.44 [1.22, 9.73] GRADE not reported 7 studies · 3930 participants |
| Tobacco use (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 2.56 [1.96, 3.34] Moderate Downgraded: inconsistency, publication bias 7 studies · 3422 participants |
| Tooth extraction (any timing) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 23.88 [0.2, 2869.91] GRADE not reported 2 studies · 1629 participants |
| Tooth extraction (any timing) (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 12.31 [6.4, 23.69] Moderate Downgraded: inconsistency 2 studies · 1629 participants |
| Tooth extraction before radiotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 0.98 [0.67, 1.45] GRADE not reported 4 studies · 17674 participants |
| Tooth extraction before radiotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 1.15 [1.01, 1.31] Moderate Downgraded: publication bias 4 studies · 17674 participants |
| Tooth extraction before radiotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 1.09 [0.75, 1.58] GRADE not reported 4 studies · 17840 participants |
| Tooth extraction after radiotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Common-effect (inverse-variance) model; primary analysis | OR 8.38 [7.2, 9.77] Moderate Downgraded: publication bias 3 studies · 17508 participants |
| Tooth extraction after radiotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Trim-and-fill sensitivity analysis (random effects) | OR 8.5 [7.34, 9.85] GRADE not reported 3 studies · 18315 participants |
| Tooth extraction after radiotherapy (frequency among patients who developed ORNJ) | Same factor among irradiated patients who did not develop ORNJ | Osteoradionecrosis of the jaws (ORNJ) Not specified · Head and neck radiotherapy; hospital and registry based observational studies · Random-effects model sensitivity analysis | OR 8.32 [7.15, 9.7] GRADE not reported 3 studies · 17508 participants |
Included primary studies 50
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Zhang 2017 matched by author and year (probable) | NR | 2 other reviews | not stated | not extracted yet |
| Liao et al., 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 |
| Bagan 2009 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Bagan et al., 2009 Osteonecrosis of the jaws by intravenous bisphosphonates and osteoradionecrosis: A comparative study DOI:10.4317/medoral.14.e616 | 2009 | this review only | not stated | not extracted yet |
| Boromand 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Boromand et al., 2023 Long-term follow-up of osteoradionecrosis of the mandible DOI:10.1080/00016357.2023.2257316 | 2023 | this review only | not stated | not extracted yet |
| Caparrotti 2017 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Caparrotti et al., 2017 Osteoradionecrosis of the mandible in patients with oropharyngeal carcinoma treated with intensity‐modulated radiotherapy DOI:10.1002/cncr.30803 | 2017 | this review only | not stated | not extracted yet |
| Chen et al., 2005 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Chopra 2011 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Chopra et al., 2011 Factors predictive of severity of osteoradionecrosis of the mandible DOI:10.1002/hed.21654 | 2011 | this review only | not stated | not extracted yet |
| Dumoulin 2020 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Dumoulin et al., 2020 Dental prevention of maxillo-mandibular osteoradionecrosis: A ten-year retrospective study DOI:10.1016/j.jormas.2020.05.022 | 2021 | this review only | not stated | not extracted yet |
| Habib 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Habib et al., 2020 Risk factors associated with osteoradionecrosis DOI:10.1111/ors.12597 | 2021 | this review only | not stated | not extracted yet |
| Khoo 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Khoo et al., 2021 Predictors of osteoradionecrosis following irradiated tooth extraction DOI:10.1186/s13014-021-01851-0 | 2021 | this review only | not stated | not extracted yet |
| Koga 2008 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Koga et al., 2008 Dental extractions related to head and neck radiotherapy: ten-year experience of a single institution DOI:10.1016/j.tripleo.2008.01.007 | 2008 | this review only | not stated | not extracted yet |
| Kojima 2017 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Kojima et al., 2017 Relationship between dental status and development of osteoradionecrosis of the jaw: a multicenter retrospective study DOI:10.1016/j.oooo.2017.04.012 | 2017 | this review only | not stated | not extracted yet |
| Kovarik 2024 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Kovarik et al., 2024 Timing of development of osteoradionecrosis post head and neck radiotherapy: does a safe time interval exist for dental extraction? DOI:10.1007/s00066-024-02251-5 | 2024 | this review only | not stated | not extracted yet |
| Kristensen et al., 2019 Osteoradionecrosis of the mandible after radiotherapy for head and neck cancer: risk factors and dose-volume correlations DOI:10.1080/0284186x.2019.1643037 | 2019 | this review only | not stated | not extracted yet |
| Kristensena 2019 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Lang 2022 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Lang et al., 2022 Frequency of osteoradionecrosis of the lower jaw after radiotherapy of oral cancer patients correlated with dosimetric parameters and… DOI:10.1186/s13005-022-00311-8 | 2022 | this review only | not stated | not extracted yet |
| Lee et al., 2009 Risk Factors and Dose–Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients DOI:10.1016/j.ijrobp.2008.12.052 | 2009 | this review only | not stated | not extracted yet |
| Liao 2020 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Liao 2021 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Liao et al., 2021 Tumor subsites and risk of osteoradionecrosis of the jaw in patients with oral cavity cancer: a national-based cohort study DOI:10.1007/s00405-020-06529-z | 2021 | this review only | not stated | not extracted yet |
| Liu et al., 2018 Nomogram model to predict postoperative relapse after mandibular osteoradionecrosis surgery DOI:10.1016/j.jcms.2018.08.010 | 2018 | this review only | not stated | not extracted yet |
| Lye et al., 2007 The effect of prior radiation therapy for treatment of nasopharyngeal cancer on wound healing following extractions: incidence of… DOI:10.1016/j.ijom.2006.11.006 | 2007 | this review only | not stated | not extracted yet |
| Niewald 1996 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Niewald 2014 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Niewald et al., 1996 Risk factors and dose–effect relationship for osteoradionecrosis after hyperfractionated and conventionally fractionated radiotherapy for… DOI:10.1259/0007-1285-69-825-847 | 1996 | this review only | not stated | not extracted yet |
| Niewald et al., 2014 Dental status, dental treatment procedures and radiotherapy as risk factors for infected osteoradionecrosis (IORN) in patients with oral… DOI:10.1186/2193-1801-3-263 | 2014 | this review only | not stated | not extracted yet |
| Renouf 2024 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Renouf et al., 2024 Prognostic Factors of Mandibular Osteoradionecrosis Including Accurate Colocalization of Avulsions and Dosimetric Dental Mapping Software,… DOI:10.1016/j.ijrobp.2024.04.019 | 2024 | this review only | not stated | not extracted yet |
| Reuther 2002 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Reuther et al., 2002 Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients—a report of a thirty year retrospective… DOI:10.1054/ijom.2002.0332 | 2003 | this review only | not stated | not extracted yet |
| Rosenfeld 2021 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Rosenfeld et al., 2021 Is the Risk to Develop Osteoradionecrosis of the Jaws Following IMRT for Head and Neck Cancer Related to Co-Factors? PMID:34064551 | 2021 | this review only | not stated | not extracted yet |
| Studer 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Studer et al., 2015 Risk profile for osteoradionecrosis of the mandible in the IMRT era DOI:10.1007/s00066-015-0875-6 | 2015 | this review only | not stated | not extracted yet |
| Thibault De Maesschalck 2016 matched by author and year (probable) | NR | this review only | Osteoradionecrosis of the jaws (ORNJ); Development of osteoradionecrosis of the jaws (ORNJ) | not extracted yet |
| Thibault De Maesschalck et al., 2016 Comparison of the incidence of osteoradionecrosis with conventional radiotherapy and intensity‐modulated radiotherapy DOI:10.1002/hed.24505 | 2016 | this review only | not stated | not extracted yet |
| Watson 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Watson et al., 2023 Development and Standardization of an Osteoradionecrosis Classification System in Head and Neck Cancer: Implementation of a Risk-Based Model DOI:10.1200/jco.23.01951 | 2024 | this review only | not stated | not extracted yet |
| Zhang et al., 2017 Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer DOI:10.1016/j.radonc.2017.05.006 | 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 question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients diagnosed with head and neck cancer | Head and neck cancer patients treated with radiotherapy (27 studies; 10 in meta-analysis) |
| Intervention | Head and neck cancer patients who received radiotherapy | Risk factors: tumor site, T and N stage, neck dissection, diabetes, oral hygiene, chemotherapy, tobacco use, tooth extraction (any, pre- and post-radiotherapy) |
| Comparison | Patients who developed ORNJ compared with those who did not | Patients with ORNJ versus patients without ORNJ (absence of each factor) |
| Outcomes | Risk factors for the development of osteoradionecrosis and imaging characteristics | Development of ORNJ (odds ratios for each factor); imaging characteristics described narratively |
| Study designs | Cross-sectional, cohort and case-control studies | 2 cross-sectional studies, 3 case-control studies, 21 retrospective cohort studies, 1 prospective cohort study (n=27) |
| Timing | Not specified | Follow-up from 1.8 to 30 years |