Table 7 Risk factors for IORN of the upper and lower jaw in the literature
Author group | Risk factor(s) | Remarks |
|---|---|---|
Ahmed et al. 2009 | Intensity modulated radiotherapy (IMRT) advantageous compared to conventional radiotherapy | |
Berger and Bensadoun 2010 | Total dose >66 Gy | Literature survey |
Bhide et al. 2012 | Total dose > 60 Gy | Literature survey |
Volume of mandible within the treatment field. Trauma related ORN after lower doses | ||
IMRT | ||
Chopra et al. 2011 | White ethnicity | |
Secondary infection | ||
Advanced age | ||
Stage IV | ||
Total dose | ||
Post-RT dental extractions | ||
Lack of pre-RT dental extractions | ||
Oral cancer | ||
Invasion of bone | ||
Tumour surgery | ||
Total radiation dose | ||
Dose rate/day | ||
Mode of radiation delivery | ||
Dental status | ||
Time from radiation therapy until the onset of ORN | ||
Goldwasser et al. 2007 | Higher body mass index | Multivariate analysis |
Use of steroids | ||
Radiation dose >66 Gy | ||
Jereczek-Fossa and Orecchia 2002 | Total dose | Literature survey, only part of the factions mentioned in the paper cited here |
Brachytherapy dose | ||
Dose per fraction | ||
Interval between fractions | ||
Volume of the horizontal ramus of the mandible irradiated with a high dose | ||
Dental status | ||
Bad oral hygiene | ||
Dental extractions after radiotherapy | ||
Katsura et al. 2008 | Oral health status after radiotherapy | |
Periodontal pocket depth | ||
Dental plaque | ||
Alveolar bone loss level | ||
Radiographic periodontal status | ||
Lee et al. 2009 | Univariate: Mandibular surgery | Multivariate analysis: |
Co-60 | Mandibular surgery | |
BED >106.2 Gy | ||
Lozza et al. 1997 | Dose rate | Brachytherapy exclusively |
Reference volume | ||
Monnier et al. 2011 | Oral cavity tumours | Multivariate analysis: bone surgery |
Bone invasion | ||
Surgery prior to radiotherapy | ||
Bone surgery | ||
Nabil 2012 | Hyperfractionation | Literature survey |
Reduced risk after accelerated radiotherapy with reduced dose | ||
Reuther et al. 2003 | Advanced tumours | |
Segmental resection of the mandible | ||
Tooth extractions (pre/post RT) | ||
Pre-surgical radiotherapy worse than post-surgical radiotherapy | ||
Store and Boysen 2000 | Tumour localization in tongue and floor of mouth | |
Trauma | ||
Thiel 1989 | Caries | |
Periondontosis | ||
Periapical pathology | ||
Injury | ||
Irritation by prostheses | ||
Dental extractions before and after radiotherapy | ||
Bone surgery because of remaining or recurrent tumours | ||
Thorn et al. 2000 | Removal of teeth | |
Surgery | ||
Injury from prosthesis | ||
Spontaneous breakdowns | ||
Tsai et al. 2012 | Total dose | |
Dental status | ||
Smokers | ||
Alcohol | ||
Larger tumours | ||
Turner et al. 1996 | Bone involvement | |
Synchronous Methotrexate | ||
Scattered dose from elective neck treatment | ||
Increasing dose | ||
Increasing target volumes for doses <55 Gy | ||
Dental extractions |