ObjectiveThe significance of pre‐hemoglobin‐to‐platelet ratio (HPR) in predicting the occurrence of radiation‐induced trismus (RIT) in locally advanced nasopharyngeal carcinoma patients (LA‐NPC) who received concurrent chemoradiotherapy (C‐CRT).MethodsThe records of LA‐NPC patients with oral examination before and after C‐CRT were analyzed. Maximum mouth openings (MMO) were measured before and after C‐CRT to confirm RIT status, with an MMO of ≤35 mm defined as RIT. HPR values were calculated on the first day of C‐CRT. The relationship between the HPR values and RIT status was discovered using the receiver operating characteristic curve analysis.ResultsA total of 43 patients RIT cases among 198 individuals were diagnosed. The optimal HPR cutoff that stratified the patients into two groups was 0.54. RIT incidence was found to be significantly higher in the HPR ≤0.54 group than its HPR >0.54 counterpart(p < 0.001). Univariately T3‐4 stage, mean masticator apparatus dose>57.2Gy, and pre‐C‐CRT MMO ≤40.7 mm were found as the other significant correlates of increased RIT rates(p < 0.05). All four variables seemed to be independently connected to greater RIT incidence in multivariate analysis (p < 0.05, for each).ConclusionThe risk of post‐C‐CRT RIT may be significantly increased when pre‐treatment HPR levels are low.

The most common indication for CBCT was malocclusion and dentomaxillofacial anomalies in the primary and permanent dentition age groups, whereas the localisation of impacted teeth was the most common indication in the mixed dentition age group. Generally, CBCT was indicated in orthodontics and surgery.

Background: To evaluate the utility of pretreatment systemic immune-inflammation index (SII) in predicting the teeth caries and need for tooth extraction after concurrent chemoradiotherapy (C-CRT) for locally advanced squamous-cell head and neck cancer (LA-SCHNC) patients. Methods: The records of LA-SCHNC patients who underwent formal dental evaluations at preand post-C-CRT periods were retrospectively analyzed. The pretreatment SII values were calculated using the platelet, neutrophil, and lymphocyte measures acquired on the first day of C-CRT: SII=Platelets×neutrophils/lymphocytes. Receiver operating characteristic (ROC) curve analysis was employed to identify the ideal pre-C-CRT SII cutoff that may predict the teeth caries and the need for tooth extraction after the C-CRT. The primary endpoint was the link between the pre-C-CRT SII and the need for tooth extraction during the follow-up period. Results: A sum of 126 patients were included. Median follow-up was 4.9 years (range: 2.7-7.8). Nasopharyngeal and laryngeal cancers comprised the majority (75.4%) study cohort. Posttreatment teeth extractions were reported in 62.7% patients. The optimal cutoff was 558 [Area under the curve (AUC): %76.8 sensitivity: 72.3%; and specificity: 70.9%] that grouped the patients into two subgroups with significantly different post-C-CRT tooth extraction rates: Group 1: SII≤558 (n = 70) and SII>558 (n = 56), respectively. Correlation analysis revealed a significant relationship between the pretreatment SII and the tooth extraction rates after the C-CRT (r s :0.89: P = 0.001). The comparative analysis displayed that the teeth extractions rates were significantly higher in the SII>558 group (77.1% versus 51.4% for SII≤558; Hazard ratio: 1.68; P = 0.001). Further analyses showed that the pre-C-CRT SII>558 was the unique factor associated with meaningfully higher necessities for post-C-CRT teeth extractions. Conclusion:The present outcomes intimated that high pretreatment SII levels were linked to significantly increased post-treatment teeth extractions in LA-SCHNC patients undergoing definitive C-CRT.

ObjectiveTo investigate the link between pretreatment neutrophil‐to‐lymphocyte ratio(NLR) and the incidence of radiation‐induced trismus(RIT) in parotid gland cancers(PGC) patients after postoperative radiotherapy(PORT).MethodData of PGC patients who had oral examinations before and after PORT were reviewed retrospectively. We comprised patients who had maximum mouth opening (MMO) assessments before and after PORT and complete blood count test on the first day of PORT. MMO of ≤35 mm was considered as RIT. The receiver operating characteristic (ROC) curve analysis was used to search for an ideal NLR threshold value that might be linked to RIT rates.ResultsFifty‐one patients were included, with a RIT incidence of 15.7%. The NLR cutoff that showed a link with the prevalence of RIT in the ROC curve analysis was 2.7[Area under the curve (AUC):82.0%; sensitivity:87.5%; specificity:74.4%]. The patients were divided into groups based on this value:Group 1: NLR≤2.7 (N = 34) and;NLR >2.7 (N = 17). In comparative analysis, the incidence of RIT was found to be statistically higher in the NLR >2.7 than counterpart (35.2%vs.5.8%;rs:0.79; p < .001). Also, a mean temporomandibular joint dose ≥51.0Gy was linked to increased RIT rates (p < .001).ConclusionThis study showed that high pre‐PORT NLR levels were a robust and independent predictor of significantly elevated rates of RIT.

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