BackgroundOsteoradionecrosis (ORN) is one of the most serious complications of head and neck radiotherapy and is considered a public health problem worldwide. This study aims to determine the prevalence and associated factors of ORN in patients undergoing radiotherapy for head and neck malignancy.Material and MethodsA cross-sectional retrospective study was conducted, in which all medical records of patients undergoing head and neck radiation in the period between 2006 to 2015 (10 years) were examined. Clinical and demographic data were extracted. Multivariate Poisson regression analysis with robust variance was employed to access the relationship between ORN and independent variables (p<0.05; 95% CI).ResultsThe sample comprised 413 medical records of patients undergoing radiotherapy. The prevalence of ORN was 9.7 %. Most participants were males (78.2%). The mean age of subjects was 55 years (± 14 years). The mandible was the main site of occurrence of ORN (85.0%). The following variables were associated with ORN : presence of oral mucositis (PR = 3.03; 95% CI: 1.30-7.03), history of smoking (PR = 0.23; 95% CI: 0.07-0.74), number of teeth removed before radiotherapy (PR = 1.06; 95% CI: 1.01-1.11) and visit to the dentist before radiation (PR = 0.08; 95% CI: 1.02-1.11).ConclusionsThe prevalence of ORN was low and was associated with the presence of oral mucositis and the number of removed teeth before radiation. Visiting the dentist before radiotherapy and stop-ping smoking were protective factors for ORN. Key words:Head and neck neoplasms, osteoradionecrosis, radiotherapy, adjuvant chemo-therapy, epidemiology.
The objective of this phase II study was to determine the effectiveness of a mucoadhesive propolis gel in the prevention of radiation-induced oral mucositis. Twenty-four patients who were selected to undergo radiation therapy for oral cancer were included in this open-label trial. They were advised to use a mucoadhesive gel containing propolis 5,0% w/v three times a day starting one day before the course of radiation therapy and concluding after 2 weeks of radiation therapy. A weekly follow-up for evaluation of food intake, pain and grading of mucositis was performed. In order to confirm the absence of Candida-related mucositis in patients who developed mucositis, it was performed exfoliative cytology of buccal mucosa, palate and tongue and the material for Candifast(®) Candida species identification. At the end of the study was made the compliance of patients, quality, appreciation and acceptance of product evaluation. Twenty patients did not develop mucositis, two patients developed grade 1 mucositis and two patients developed grade 2 mucositis. None of the patients discontinued food intake and no pain was observed during the study. Candidosis was not detected in any patient. Mucoadhesive propolis gel could be considered as a potential topical medication for preventing radiation-induced oral mucositis. However, comparative phase III study with larger number of patients should be done for confirmation of the efficacy of the product.
a b s t r a c tLipoma is the most common benign mesenchymal soft tissue neoplasm in adults. It is rarely seen in the oral cavity and comprises 1-4% of all benign oral lesions. There are different types of lipomatous tumors that contain other predominant mesenchymal elements such as cartilaginous/osseous tissues. Osteolipoma is a rare histopathologic variant of lipoma accounting for less than 1% of all lipomatous cases. Eight cases of this type of lipoma were reported in the mandibular buccal vestibule. The present study aims to report a rare condition: a patient with osteolipoma situated in the mandibular region. In addition, a literature review is presented.
Background: Orofacial pain (OFP) is an undesirable sensation frequently associated with head and neck cancer (HNC) and its treatment. OFP negatively impacts the quality of life of oncological patients. The approach to OFP diagnosis and management can differ if the patient visits a dentist or physician. The aim of this study was to present a case series of HNC with OFP managed by a dentist team and to discuss its role in the management of OFP. Material and Methods: We recruited twenty-two adult patients with OFP and previous diagnosis of HNC referred to an academic dental clinic from 2015 to 2017. Results: Nociceptive was more frequent than mixed and neuropathic pain, however 54,4% of the cases showed a neurological component. All types of pain were managed by dentist through removal of pain's cause and appropriated local and systemic treatment. The intensity of pain was reduced in 86,3% of patients, and 45,4% of them reported absence of pain at the end of treatment. Conclusions: Dentist's assessment plays a distinct and crucial role in the diagnosis and management of OFP in HNC patients throughout the oncological treatment.
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