Denture use and osteoradionecrosis following radiotherapy for head and neck cancer: A systematic review

Gerodontology. 2020 Jun;37(2):102-109. doi: 10.1111/ger.12456. Epub 2019 Dec 30.


Background: It is strongly recommended to extract teeth with poor prognosis in head and neck cancer (HaNC) patients prior starting treatment with radiotherapy to avoid need for extraction post-radiotherapy and prevent development of osteoradionecrosis (ORN). Dental extraction means that patients are often left with insufficient teeth leading to psychological problems and reducing their quality of life post-radiotherapy. Some clinicians do not advocate the use of dentures in HaNC patients claiming that dentures might lead to soft tissue irritation followed by ORN when constructed on irradiated jaws.

Aims: This systematic review aimed to investigate the existing evidence regarding the impact of denture use on the development of ORN in HaNC patients post-radiotherapy.

Methods: This systematic review followed the Preferred Reporting Item for Systematic Review and Meta-analyses (PRISMA) guideline. Three database systems were used: Ovid Medline, EMBASE and PsycINFO. PROSPERO was searched for ongoing or recently completed systematic reviews. The was searched for ongoing or recently completed trials. The Joanna Briggs Institute critical appraisal tools were used to assess quality of studies being reviewed.

Results: Only three retrospective case-control studies were included. Numbers of participants included in the three studies are limited with incomparable types of mucosal dentures. None of the studies described the method of measurement of the exposure (denture use) in a standard, validated and reliable way.

Conclusion: The three included studies suggested no link between denture use and development of ORN. However, very little evidence exists and the robustness of the studies is questionable. Well-powered studies are needed.

Keywords: dentures; head and neck neoplasms; osteoradionecrosis; radiotherapy; teeth extraction.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Dentures
  • Head and Neck Neoplasms*
  • Humans
  • Osteoradionecrosis*
  • Quality of Life
  • Retrospective Studies