Non-Cochrane · prognostic · PM42645495
Periodontal Disease and Risk of Osteoradionecrosis in Patients with Head and Neck Cancer Undergoing Radiotherapy: A Systematic Review and Meta-Analysis.
Zambrano Manzaba Gabriela Guadalupe, Narvaez Guerrero Jossue Tarquino, Chauca-Bajaña Luis, et al. · Dentistry journal · 2026 · PubMed · doi:10.3390/dj14080520
Findings
Population Adult patients with head and neck cancer undergoing radiotherapy
9 findings
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Leave-one-out: omitting Schuurhuis 2011 | Pooled relative effect estimate (HR/OR/RR) 4.55 [1.63, 12.69] GRADE not reported 5 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Sensitivity: Hartung-Knapp adjusted random-effects model | Pooled relative effect estimate (HR/OR/RR) 4.82 [1.50, 15.51] GRADE not reported 6 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Primary analysis, random-effects inverse-variance (DerSimonian-Laird) | Pooled relative effect estimate (HR/OR/RR) 4.83 [1.96, 11.93] GRADE not reported 6 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Leave-one-out: omitting Kojima 2017 | Pooled relative effect estimate (HR/OR/RR) 6.77 [2.65, 17.32] GRADE not reported 5 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Leave-one-out: omitting Ito 2020 | Pooled relative effect estimate (HR/OR/RR) 3.80 [1.45, 9.97] GRADE not reported 5 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Sensitivity: excluding Katsura 2008 (also leave-one-out) | Pooled relative effect estimate (HR/OR/RR) 3.94 [1.66, 9.35] GRADE not reported 5 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Sensitivity: excluding Schuurhuis 2018 (also leave-one-out) | Pooled relative effect estimate (HR/OR/RR) 6.03 [2.32, 15.67] GRADE not reported 5 studies |
| Periodontal disease or poor periodontal status (exposure) | No periodontal disease, healthy or mild periodontal status | Osteoradionecrosis of the jaws Leave-one-out: omitting Owosho 2017 | Pooled relative effect estimate (HR/OR/RR) 4.81 [1.59, 14.55] GRADE not reported 5 studies |
| Radiotherapy for head and neck cancer | None | Prevalence of osteoradionecrosis of the jaws | Pooled prevalence 0.09 [0.06, 0.13] GRADE not reported 7 studies · 1785 participants |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Benito-Ramal 2024 Prevalence and risk factors of chronic oral complications in head and neck cancer therapies: A retrospective study. PMID:39396141 | 2024 | this review only | not stated | not extracted yet |
| Ito 2020 Risk assessment of osteoradionecrosis associated with periodontitis using 18F-FDG PET/CT. PMID:33012550 | 2020 | this review only | Osteoradionecrosis of the jaws; Prevalence of osteoradionecrosis of the jaws | not extracted yet |
| Katsura 2008 Relationship between oral health status and development of osteoradionecrosis of the mandible: a retrospective longitudinal study. PMID:18329913 | 2008 | this review only | Osteoradionecrosis of the jaws; Prevalence of osteoradionecrosis of the jaws | not extracted yet |
| Khaw 2014 Influence of periodontitis on the experience of oral mucositis in cancer patients undergoing head and neck radiotherapy: a pilot study. PMID:24647487 | 2014 | this review only | not stated | not extracted yet |
| Kojima 2017 Relationship between dental status and development of osteoradionecrosis of the jaw: a multicenter retrospective study. PMID:28606831 | 2017 | this review only | Osteoradionecrosis of the jaws; Prevalence of osteoradionecrosis of the jaws | not extracted yet |
| Morais 2020 A prospective study on oral adverse effects in head and neck cancer patients submitted to a preventive oral care protocol. PMID:31900618 | 2020 | this review only | not stated | not extracted yet |
| Niewald 2013 Dental status, dental rehabilitation procedures, demographic and oncological data as potential risk factors for infected… PMID:24088270 | 2013 | this review only | Prevalence of osteoradionecrosis of the jaws | not extracted yet |
| Owosho 2017 The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with… PMID:28024723 | 2017 | this review only | Osteoradionecrosis of the jaws; Prevalence of osteoradionecrosis of the jaws | not extracted yet |
| Schuurhuis 2011 Efficacy of routine pre-radiation dental screening and dental follow-up in head and neck oncology patients on intermediate and late… PMID:22001103 | 2011 | this review only | Osteoradionecrosis of the jaws; Prevalence of osteoradionecrosis of the jaws | not extracted yet |
| Schuurhuis 2018 Patients with advanced periodontal disease before intensity-modulated radiation therapy are prone to develop bone healing problems: a… PMID:29090383 | 2018 | this review only | Osteoradionecrosis of the jaws; Prevalence of osteoradionecrosis of the jaws | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients (>=18 years) with head and neck cancer treated with radiotherapy | Patients with head and neck cancer treated with radiotherapy (n=1785 in the prevalence analysis) |
| Intervention | Exposure: periodontal disease or poor periodontal status (clinical, radiographic or imaging assessed) | Periodontal disease or poor periodontal status (heterogeneous definitions; 6 studies in the association analysis) |
| Comparison | Patients without periodontal disease, with healthy periodontal status, or with mild periodontal involvement | Absence of periodontal disease or better periodontal status |
| Outcomes | Primary: osteoradionecrosis of the jaws; secondary: pooled ORN prevalence and qualitative evidence on other radiotherapy-related oral complications | Osteoradionecrosis (pooled relative effect estimate 4.83; pooled prevalence 9%, 7 studies, 118 events) |
| Study designs | Observational studies (prospective and retrospective cohort, case-control, nested case-control, cross-sectional) | 10 observational studies included (6 in association meta-analysis, 7 in prevalence meta-analysis) |
| Timing | Not specified | Follow-up from 12 months to over 4 years across studies |