SynthesisClinical oral investigations2026
Identifying risk factors for osteoradionecrosis of the jaws: a systematic review and meta-analysis.
Synthesis in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
objectivesOsteoradionecrosis of the jaws (ORNJ) is a severe complication of head and neck radiotherapy associated with substantial morbidity. This study aimed to identify factors associated with ORNJ. MATERIALS AND
methodsThis systematic review followed PRISMA and Cochrane guidelines. PubMed, Scopus, Web of Science, SciELO, Embase, LILACS, and the Cochrane Library were searched for observational studies on ORNJ. Clinical characteristics, risk factors, radiological findings, and risk of bias were assessed.
resultsOf 627 records, 27 studies were included in qualitative synthesis and 10 in meta-analysis. Computed tomography was the most frequently used imaging method, and sample selection was the main methodological limitation. Meta-analysis identified associations with smoking (OR = 2.56; p < 0.0001), post-radiotherapy dental extractions (OR = 8.38; p < 0.0001), oropharyngeal tumors (OR = 2.35; p < 0.0001), T2 stage (OR = 1.78; p = 0.0002), T4 stage (OR = 1.98; p = 0.0002), and oral cavity (OR = 4.00/ p < 0.0001); good oral hygiene was protective (OR = 0.40; p = 0.0057).
conclusionSmoking, post-radiotherapy dental extractions, oral cavity and oropharyngeal tumors, and T2 and T4 tumor stages were associated with increased odds of ORNJ, whereas good oral hygiene showed a protective effect. These findings reinforce the importance of minimizing post-radiotherapy extractions and maintaining rigorous oral hygiene in patients undergoing head and neck radiotherapy. CLINICAL RELEVANCE: Identifying modifiable risk factors may support prevention, surveillance, and individualized management of ORNJ in patients receiving head and neck radiotherapy through integrated multidisciplinary clinical and dental care.
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