Table 1.

Inclusion and exclusion criteria adopted for this systematic review.

Inclusion Criteria

Full papers, literature in English language, published after 1978 in peer-reviewed journals

Observational clinical studies, both prospective and retrospective (cohort and case-control), and RCTs

Minimum sample size of 10 patients who underwent tooth extractions after radiotherapy in an H&N district

No previous ORN at the extraction site

Mean 6 months follow-up after tooth extractions

Unhealed sockets followed up for at least 3 months

Exclusion criteria

Case reports, reviews, cross-sectional studies

Studies in which no clear definition of ORN was reported

Studies not specifying whether ORN developed at the extraction site.

Studies on therapies of patients with ORN were included only if the ORN was effectively due to dental extractions and if the total number of patients receiving tooth extractions was clearly stated. Because many definitions of ORN have been proposed, confusion exists regarding its diagnosis, mainly concerning the time of bone exposure. The assessment of the period of bone exposure is crucial to achieving an ORN diagnosis, because it is not possible to clinically distinguish between a delayed alveolar bone healing and a true ORN. In this revision, studies without a clear definition of ORN were excluded to avoid biases. Abbreviations: ORN, osteoradionecrosis; RCTs, randomized clinical trials; H&N, head and neck.