Incidence of osteoradionecrosis of the jaws: a retrospective study of 620 patients with head and neck cancer.

This study aimed to assess systemic and local risk factors for the development of osteoradionecrosis (ORN) of the jaws and its incidence in patients with head and neck cancer undergoing radiotherapy (RT). This was a retrospective cohort study of 620 adults following irradiation for head and neck cancer in 2011 or 2012. Among 181 patients who did not require any tooth extractions, the incidence of ORN was 0.5%. Among 266 patients with a total of 1491 tooth extractions (mean, 5.5 teeth per patient) performed before RT, the incidence of ORN was 3.7%. In all cases, ORN was observed in extraction sites located in the field of radiation. No extractions were performed during RT. Fifteen patients underwent extractions both before and after RT. Of the 53 tooth extractions performed after RT (20 patients; mean, 2.7 teeth per patient), 15 were in the field of radiation. No case of ORN was reported in that group. Among 168 edentulous patients, the incidence of ORN was 1.8%. Within the limitations of this study, the results suggest that the incidence of ORN can be minimized with a meticulous pre-RT dental examination, a comprehensive treatment plan, and diligent post-RT follow-up examinations conducted by an experienced multidisciplinary team.

Platelet-rich fibrin as a treatment option for osteoradionecrosis: A literature review.

The aim of this review is to establish the usefulness and effectiveness of using platelet-rich fibrin (PRF) in the treatment of osteoradionecrosis (ORN) lesions. A review of the literature was performed using keywords through the PubMed-Medline and Cochrane Library search engine. Inclusion criteria were: (1) original publication in either the French or the English language, (2) studies conducted in humans, (3) presence of ORN lesions following head and neck radiotherapy (RT), (4) use of PRF or derivates in the treatment of ORN lesions, (5) clinical variables and outcomes mentioned in the study. Overall, four case reports were retained. Two publications were removed from the initial seven results after application of the inclusion criteria. A recent randomised clinical trial was not considered since the group analysed the effectiveness of leukocyte-enriched Plasmas-Rich-Fibrin (LPRF) in preventing ORN, but not in treating it. Therefore, four publications were retained for analysis. Results suggest that using PRF as an adjunct to surgical therapy is beneficial in treating ORN lesions although no controlled studies were found. Therefore, additional controlled clinical studies are warranted to better define the effectiveness and recommendation of this approach.

Voicing Beliefs on Global Leadership for Dentistry.

BACKGROUND: Dental leadership in different models of care is not well documented, and therefore the objectives of this study were to explore how dental leaders develop their own leadership and how they engage others to increase access to oral health services as well as to describe perceived challenges in developing coalitions for promoting oral health care. METHODS: We adopted a qualitative descriptive research methodology. We recruited dental leaders using a purposeful sampling approach and a snowball technique. Data were collected using a remote digital platform; we organised semi-structured interviews based on the LEADS conceptual framework. Saturation was reached after 11 interviews. Data analysis included the following iterative steps: decontextualisation, recontextualisation, categorisation, and data compilation. The analysis was performed manually, assisted by the use of QDA Miner software. RESULTS: Fourteen dental leaders participated in the study. Our analysis revealed 3 overarching themes: (I) lead self, with 3 subthemes: leadership insights; leadership traits; opportunity-role model dyad; (II) leadership strategies; and (III) challenges in leadership development, with 3 subthemes: limited engaged practice and workforce, valorise the image of dentistry, and lack of leadership training. CONCLUSIONS: Our research findings showed that, despite a limited scope of leadership in dentistry, the dental leaders recognise its importance and acknowledge the need for formal training and mentorship at different levels. This study identified challenges in dental leadership development that could further orient dental education programmes and support the implementation of evidence-based, high-quality, and efficient oral health services.