The incidence of osteoradionecrosis of the jaws in oral cavity cancer patients treated with intensity-modulated radiotherapy: a systematic review and meta-analysis.

OBJECTIVE: A systematic review with meta-analysis was conducted to define the incidence of osteoradionecrosis (ORN) in patients with oral cavity cancer (OCC) treated with intensity-modulated radiotherapy (IMRT), and to identify the risk factors influencing its development. STUDY DESIGN: Six databases were searched systematically. A meta-analysis was performed to determine overall, spontaneous, and dental extraction-attributed incidences of ORN. The Grading of Recommendations Assessment, Development, and Evaluation tool evaluated evidence certainty. RESULTS: Out of 11 eligible studies, 6 underwent meta-analysis for the overall aggregated ORN incidence in OCC patients receiving IMRT, resulting in an incidence rate of 8% (95% CI: 6%-11%). Regarding development reasons, 2 studies were assessed, revealing an incidence of 36% (95% CI: 1%-98%) for spontaneous ORN, and 17% (95% CI: 5%-44%) ensued from dental extraction exclusively pre-RT. All rates had very low certainty of evidence. Factors significantly correlated with ORN development included postoperative RT use (78%), employment of therapeutic doses above 50 Gy, and mandibular involvement (80.5%). CONCLUSION: The findings suggest that IMRT alone is not sufficient to decrease ORN rates in OCC patients, underscoring the importance of precisely identifying the involved risk factors. However, further detailed primary studies will be necessary.

Chlorinated-based bioceramics incorporated in polycaprolactone membranes.

The development of bioactive membranes with bone repair properties is great interest in the field of tissue engineering. In this study, we aimed to fabricate and characterize a composite membrane composed of sol-gel synthesized bioceramics and electrospun polycaprolactone (PCL) fibers for bone tissue regeneration applications. The bioceramics were prepared using the sol-gel method with nitrate (N) and chloride (CL) as precursors. PCL and bioceramic solutions were electrospun to obtain ultrafine fiber mats. Raman spectroscopy, x-ray diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM) were used to characterize the materials. The results showed that both chlorinated and non-chlorinated bioceramics contained NBOs (non-bridge bonds) and crystallized the α-wollastonite phase, with the chlorinated version doing so at lower temperatures. In vitro tests were performed to evaluate cytotoxicity, cell adhesion, and mineralized matrix formation on the membranes. The composite membranes showed improved cell viability and promoted mineralization nodules formation. This study presents a promising approach for the development of bioactive membranes for bone tissue engineering, with potential applications in bone regeneration therapies.