Melhor momento para realizar exodontia em pacientes oncológicos visando prevenir a osteorradionecrose

Abstract

Osteoradionecrosis is a pathology that is characterized by bone exposure present for more than three months in a site submitted to radiotherapy, not being related to a tumor. It has a long and difficult treatment. It is triggered, among other factors, by tooth extractions in patients undergoing radiotherapy, as this type of treatment causes low cellularity and vascularity in the periosteum that has undergone irradiation, resulting in non-healing of the surgical wound and, consequently, bone necrosis. However, many cancer patients need to undergo tooth extraction procedures. This work aimed to investigate what is the best time to perform dental extractions in patients treated with radiotherapy, in order to prevent the appearance of osteoradionecrosis. A literature review was performed using the PubMed database, considering a period from 1970 to 2022, using the search terms: “tooth” AND “extraction” AND “osteoradionecrosis” AND “radiotherapy”. After analyzing the consulted literature in detail, 33 articles were included in this literature review. Most of the literature suggests that the best time to perform tooth extractions would be before radiotherapy. There was variation in the time interval, from seven days to three months, with most recommending 14 days. If the extractions are after radiotherapy, they should be performed between 1 and 6 months. Recent studies show that time may not be the determining factor for the emergence of the disease.