Impacted Tooth Management and Osteoradionecrosis Risk in NPC

This multicenter, randomized controlled trial is designed to determine whether omitting prophylactic extraction of impacted teeth before radiotherapy leads to an unacceptably higher risk of jaw osteoradionecrosis (JORN) compared with conventional prophylactic extraction in patients with non-metastatic nasopharyngeal carcinoma (NPC). JORN is a condition in which jawbone tissue is damaged and fails to heal properly after radiotherapy. A total of 536 eligible participants with at least one impacted tooth will be randomly assigned to either omit prophylactic extraction of impacted teeth before radiotherapy or undergo conventional prophylactic extraction before radiotherapy. All participants will receive standard curative-intent intensity-modulated radiotherapy (IMRT), with chemotherapy administered when indicated according to the study protocol. Participants will be followed for up to 5 years. The primary outcome is the incidence of JORN within 2 years after completion of radiotherapy. Secondary outcomes include longer-term incidence of JORN, overall survival, locoregional relapse-free survival, distant metastasis-free survival, quality of life, and treatment-related toxicities.

NCT Number	NCT07764887
Lead Sponsor	First Affiliated Hospital of Guangxi Medical University Collaborators: People's Hospital of Guangxi Zhuang Autonomous Region, LiuZhou People's Hospital, Liuzhou Workers' Hospital, Wuzhou Red Cross Hospital, Guigang People's Hospital, First People's Hospital of Yulin, Affiliated Hospital of Guilin University, Youjiang Medical College for Nationalities
Conditions	Nasopharyngeal Carcinoma (NPC), Osteoradionecrosis of the Jaw
Enrollment	536 participants
Start Date	2026-08-30
Primary Completion	2029-11-30 (estimated)
Study Completion	2032-11-30 (estimated)
Updated on ClinicalTrials.gov	2026-08-14