Relationship between dental status and development of osteoradionecrosis of the jaw: a multicenter retrospective study.

OBJECTIVE: Osteoradionecrosis of the jaw is a serious late adverse event in patients with head and neck cancer undergoing radiotherapy. The aim of this study is to investigate the relationship between dental status and development of osteoradionecrosis. STUDY DESIGN: Multicenter, retrospective observational study. A total of 392 patients with head and neck cancer who underwent radiotherapy were investigated for correlations between the development of osteoradionecrosis and various factors. The cumulative occurrence rate of osteoradionecrosis was calculated by the Kaplan-Meier method and analyzed by Cox regression and log-rank test. RESULTS: Osteoradionecrosis developed in 30 of 392 patients. In 23 patients, osteoradionecrosis occurred in the mandibular molar region. A univariate analysis showed that oral or oropharyngeal cancer, jaw radiotherapy dose exceeding 50 Gy, periapical periodontitis, and tooth extraction after radiotherapy were significantly correlated with the occurrence of osteoradionecrosis. Among these, oral and oropharyngeal cancer, periapical periodontitis, and tooth extraction after radiotherapy were significant independent risk factors by multivariate analysis. Further, caries that occurred after radiotherapy and progressed rapidly, resulting in periapical periodontitis, carious stump, or extraction, was a major cause of osteoradionecrosis. CONCLUSION: Extraction of mandibular molars with periapical periodontitis before radiotherapy and strict dental management after radiotherapy may reduce the risk of osteoradionecrosis.

Survey on awareness of folic acid recognition and intake by female students.

To reduce the risk of neural tube defects, studies have been conducted on female students of medical services, nutritional science, and nursery education that investigated the awareness of folic acid by using questionnaires. Many investigators have suggested the need to provide detailed information about the awareness of folic acid and knowledge about folic acid intake and neural tube defect risk reduction. The dietary habits of female students showed a positive correlation with their estimated folic acid intake, suggesting that improvements in dietary habits are associated with the consumption of folic acid. The importance of folic acid intake must be more aggressively promoted among female students. Thus, many learning opportunities should be provided for such students to help increase their folic acid intake.

Crestal Approach to Sinus Floor Elevation for Atrophic Maxilla Using Platelet-Rich Fibrin as the Only Grafting Material: A 1-Year Prospective Study.

PURPOSE: Platelet-rich fibrin (PRF) has been recently used as the sole grafting material in sinus floor elevation procedures. The aim of this prospective study was to measure the bone gain around the dental implant after using the crestal approach to sinus floor elevation using platelet-rich fibrin as the only grafting material in atrophic posterior maxillae with residual bone height <5 mm. MATERIALS AND METHODS: Two different types of implants were used: hydroxyapatite (HA) and sandblasted acid-etched (SA) implants. Panoramic radiography and computed tomography were used to measure the endosinus bone gain. RESULTS: Twenty-seven patients with 39 implants (19 HA and 20 SA) were included in this study. The mean residual bone measurements before surgery in the SA and HA groups were 2.85 and 2.68 mm, respectively. The mean average bone gains for 1 year in the SA and HA groups were 4.38 and 4.00 mm, respectively. CONCLUSION: This prospective study showed that platelet-rich fibrin promoted endosinus bone gain when used as the grafting material in the crestal approach to sinus floor elevation.