Management of patients at risk of osteoradionecrosis: results of survey of dentists and oral & maxillofacial surgery units in the United Kingdom, and suggestions for best practice
Management of patients at risk of osteoradionecrosis: results of survey of dentists and oral & maxillofacial surgery units in the United Kingdom, and suggestions for best practice
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DOI：
10.1016/j.bjoms.2009.06.128
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发表时间：
2010-06-01
影响因子：
1.8
通讯作者：
Brennan, Peter A.
中科院分区：
文献类型：
--
作者：
McLeod, Niall M. H.;Bater, Michael C.;Brennan, Peter A.
我们的目的是找出牙科医生是否采取具体措施，以确定谁是在风险的颌骨骨放射性坏死（ORN）的患者，口腔颌面外科单位在英国如何管理的患者进行了放射治疗，并需要拔牙，以及目前的做法背后的证据，我们发出了邮寄问卷调查60牙医和117颌面单位。牙医被问及用于识别放疗患者的措施，以及抗生素预防的使用。颌面部单位被问及是否存在书面协议和用于最大限度地减少ORN风险的措施。35%的受访牙医特别询问头颈部癌症或放射治疗作为其病史的一部分，5%的受访颌面部单位有书面协议，用于管理接受过放射治疗或以前被诊断为ORN的患者。16%的牙医和81%的颌面部单位建议对有ORN风险的患者使用预防性抗生素。59%的颌面部单位推荐术前漱口，识别有ORN风险的患者是预防ORN的第一步，但目前还没有有效地完成。建议包括术前使用漱口水和预防性抗生素。手术应该是无创伤的，应该由经验丰富的临床医生完成。(C)2009年英国口腔颌面外科医师协会。由爱思唯尔有限公司出版。保留所有权利。
We aimed to find out whether dental practitioners take specific measures to identify patients who are at risk of osteoradionecrosis (ORN) of the jawbones; how oral and maxillofacial surgery units in the United Kingdom manage patients who have had radiotherapy and require dental extractions, and the evidence behind current practice.We sent postal questionnaires to 60 dentists and 117 maxillofacial units. Dentists were questioned about measures used to identify radiotherapy patients, and use of antibiotic prophylaxis. Maxillofacial units were questioned about the existence of written protocols and the measures used to minimise the risk of ORN.Thirty-five percent of dentists questioned ask specifically about head and neck cancer or radiotherapy as part of their medical history, and 5% of maxillofacial units questioned had written protocols for the management of patients who had had radiotherapy or had previously been diagnosed with ORN. Prophylactic antibiotics are recommended for patients at risk of ORN by 16% of dentists and 81% of maxillofacial units. Preoperative mouthwash is recommended by 59% of maxillofacial units.Identification of patients at risk of ORN is the first step in prevention but it is not done efficiently at present. Recommendations include the use of preoperative mouthwash and prophylactic antibiotics. Operations should be atraumatic and should be done by experienced clinicians. (C) 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.