在放射治疗后计划拔牙
Matthew C Ward1,2, Cathleen M Petersen3, Jenene Noll3
1Levine Cancer Institute, Atrium Health, Charlotte, North Carolina.
JAMA otolaryngology-- head & neck surgery
|August 8, 2024
概括
放射治疗 (RT) 后的牙提取具有重大风险,在RT后立即进行手术的患者中,暴露骨的发生率为40%. 这凸显了延迟必要的牙科护理的患者的潜在并发症.
科学领域:
- 口腔和牙面部外科手术
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
背景情况:
- 放射前治疗 (RT) 牙提取是无法恢复的牙的标准.
- 在RT提取之前,RT启动的延迟可能会发生.
- 术后拔牙是一种替代方案,但结果不确定.
研究的目的:
- 评估放射治疗后立即进行牙提取的可行性和安全性.
- 为了评估并发症的风险,特别是暴露的膜骨,在RT后的提取后.
主要方法:
- 一项前性队列研究,涉及50名推推的RT前牙提取推迟的患者.
- 患者在RT后接受了牙提取,理想情况下是在4个月内.
- 主要结局是暴露的膜骨的累积发病率,使用灰色方法分析死亡作为竞争风险.
主要成果:
- 在50名患者中,有30名患者接受了8.5次提取的中位数,RT后的中位数为64.5天.
- 暴露骨的2年累计发病率总体为27%.
- 经过RT后提取的患者有40%的暴露骨的发生率,而那些没有经过RT后提取的患者的发生率为7%. 证实了8例骨质放射性死病例.
结论:
- 辐射后的牙提取,即使在4个月内,也与暴露的膜骨的相当大的风险有关.
- 这些发现表明,延迟牙提取到放射治疗后可能会增加像骨质放射性死等并发症的风险.
- 在考虑放射后的牙科手术时,仔细选择患者和风险益处评估至关重要.
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