Using Electronic Dental Records to Assess Osteoradionecrosis Risk in Irradiated Head and Neck Cancer

Area of Science:

• Oncology
• Oral Surgery
• Radiotherapy

Background:

• Osteoradionecrosis of the jaw (ORNJ) is a significant complication following radiation therapy for head and neck cancers.
• Recent trends suggest a decrease in ORNJ likelihood after tooth extraction, necessitating further investigation into contributing factors.

Purpose of the Study:

• To identify potential risk factors for ORNJ in patients with head and neck cancer who have undergone irradiation.
• To explore the utility of electronic dental records (EDRs) for identifying these risk factors.

Main Methods:

• Retrospective cohort analysis of 359 patients with head and neck cancer treated with irradiation between 2010 and 2020.
• Data extraction and quality assessment from EDRs, categorizing potential risk factors including patient, tumor, systemic, oral, treatment, and radiation details.
• Multivariate logistic regression analysis to determine significant predictors of ORNJ.

Main Results:

• Smoking (OR=9.0, P=0.006), steroid use (OR=6.4, P=0.021), poor oral health status (OR=23.7, P=0.005), and post-irradiation extraction (OR=3.8, P=0.050) were significantly associated with increased ORNJ risk.
• EDR data quality was generally sufficient, except for radiation-related factors, which were poorly documented.

Conclusions:

• Smoking, steroid use, poor oral health, and post-irradiation extraction are key risk factors for ORNJ in irradiated head and neck cancer patients.
• EDRs are a valuable tool for identifying ORNJ risk factors, aiding clinical decision-making.
• Improved documentation of radiation-related factors in EDRs is recommended.