[Postradiation dental extractions].
BACKGROUND
Healing may fail after postradiation dental extractions, with a risk of followed osteoradionecrosis, and its dramatic prognosis. We propose a protocol for postradiation extractions.


METHODS
From January 2000 to December 2001, 107 patients underwent 287 dental extractions after radiation therapy: 80.5% in mandibular jaw, average radiation dose 61.6 Gy, average time between radiation and extraction 6 years. Extractions were performed under general anesthesia, diazanalgesia or local anesthesia, and extraction wounds were sutured after insertion of a collagenic sealant impregnated with gentamicin. General antibiotic prophylaxy was given.


RESULTS
Healing failed in only two cases. The first case involved early-stage osteoradionecrosis and the second a tumoral localization. The rate of post-extraction osteoradionecrosis was thus 0.35%.


CONCLUSIONS
A strict protocol associating non-traumatic surgery and an alveolar sealant can considerably decrease the risk of osteoradionecrosis after dental extraction in radiated bone.
Chaux-Bodard
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AG
Centre Léon Bérard, 28, rue Laennec, 69373 Lyon 08. anneetsteph.bod@freesbee.fr
Gourmet
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Montbarbon
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Bodard
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Breton
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P
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008334:Mandible / Q000528:radiation effects*; D008336:Mandibular Diseases / Q000517:prevention & control; D008437:Maxilla / Q000528:radiation effects*; D008439:Maxillary Diseases / Q000517:prevention & control; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000517:prevention & control; D011878:Radiotherapy; D011879:Radiotherapy Dosage; D013536:Suture Techniques; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use; D014081:Tooth Extraction; D014945:Wound Healing / Q000187:drug effects
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014014:Tissue Adhesives; D003094:Collagen