Table 8.
Risk factors for IORN of the upper and lower jaw in the literature
| Author group | Year of publication | Risk factor(s) | Remarks |
|---|---|---|---|
| Ahmed et al. [30] |
2009 |
Intensity modulated radiotherapy (IMRT) advantageous compared to conventional radiotherapy |
|
| Berger et al. [14] |
2010 |
Total dose >66Gy |
Literature survey |
| Bhide et al. [31] |
2012 |
Total dose > 60Gy |
Literature survey |
| Volume of mandible within the treatment field. Trauma related ORN after lower doses | |||
| IMRT | |||
| Chopra et al. [32] |
2011 |
White ethnicity |
|
| Secondary infection | |||
| Advanced age | |||
| Stage IV | |||
| Total dose | |||
| Post-RT dental extractions | |||
| Lack of pre-RT dental extractions | |||
| Goldwasser et al. [33] |
2007 |
Higher body mass index |
Multivariate analysis |
| Use of steroids | |||
| Radiation dose >66Gy | |||
| Jerecek-Fosså et al. [17] |
2002 |
Total dose |
Literature survey, only part of the factions mentioned in the paper cited here |
| Brachytherapy dose | |||
| Dose per fraction | |||
| Interval between fractions | |||
| Volume of the horizontal ramus of the mandible irradiated with a high dose | |||
| Dental status | |||
| Bad oral hygiene | |||
| Dental extractions after radiotherapy | |||
| Katsura et al. [18] |
2008 |
Oral health status after radiotherapy |
|
| Periodontal pocket depth | |||
| Dental plaque | |||
| Alveolar bone loss level | |||
| Radiographic periodontal status | |||
| Lee et al. [19] |
2009 |
Univariate: Mandibular surgery |
Multivariate analysis: Mandibular surgery |
| Co-60 |
BED >106.2Gy |
||
| Lozza et al. [35] |
1997 |
Dose rate |
Brachytherapy exclusively |
| Reference volume | |||
| Curi et al. [3] |
1997 |
Oral cancer |
|
| Invasion of bone | |||
| Tumour surgery | |||
| Total radiation dose | |||
| Dose rate/day | |||
| Mode of radiation delivery | |||
| Dental status | |||
| Time from radiation therapy until the onset of ORN | |||
| Monnier et al. [20] |
2011 |
Oral cavity tumours |
Multivariate analysis: bone surgery |
| Bone invasion | |||
| Surgery prior to radiotherapy | |||
| Bone surgery | |||
| Nabil et al. [36] |
2012 |
Hyperfractionation |
Literature survey |
| Reduced risk after accelerated radiotherapy with reduced dose | |||
| Reuther et al. [4] |
2003 |
Advanced tumours |
|
| Segmental resection of the mandible | |||
| Tooth extractions (pre/post RT) | |||
| Pre-surgical radiotherapy worse than post-surgical radiotherapy | |||
| Støre and Boysen [37] |
2000 |
Tumour localization in tongue and floor of mouth |
|
| trauma | |||
| Thiel et al. [38] |
1989 |
Caries |
|
| Periondontosis | |||
| Periapical pathology | |||
| Injury | |||
| Irritation by prostheses | |||
| Dental extractions before and after radiotherapy | |||
| Bone surgery because of remaining or recurrent tumours | |||
| Thorn et al. [39] |
2000 |
Removal of teeth |
|
| Surgery | |||
| Injury from prosthesis | |||
| Spontaneous breakdowns | |||
| Tsai et al. [27] |
2013 |
Total dose |
|
| Dental status | |||
| Smokers | |||
| Alcohol | |||
| Larger tumours | |||
| Turner et al. [24] |
1996 |
Bone involvement |
|
| Synchronous Methotrexate | |||
| Scattered dose from elective | |||
| neck treatment | |||
| Increasing dose | |||
| Increasing target volumes for doses <55Gy | |||
| Dental extractions |