Incidence of osteoradionecrosis following oral and maxillofacial surgery in irradiated head and neck cancer patients

Aim The aim of this study was to investigate the incidence of osteoradionecrosis following various surgical procedures, including tooth extraction, periodontal surgery, pre‐prosthetic surgery, removal of bone spicules and removal of bone reconstruction/osteosynthesis plates. Material and methods The charts of 68 patients who had undergone post‐radiotherapy surgical procedures were reviewed. The following information was obtained: gender, age, radiotherapy dose and field, type of surgical procedure and time between the end of radiotherapy and the surgical procedure. Results Osteoradionecrosis developed in 14 patients and did not statistically correlate with gender, radiotherapy dose and field or time between the end of radiotherapy and the surgical procedure. Removal of bone spicules was significantly associated with osteoradionecrosis (P = 0.033), compared with tooth extraction, pre‐prosthetic surgery, removal of reconstruction/osteosynthesis plates and periodontal surgery. Conclusions Our findings show removal of bone spicules is a significant risk factor for the development of osteoradionecrosis, suggesting that careful evaluation and management of spicules in previously irradiated patients is particularly important in the prevention of osteoradionecrosis.