Pre-Radiation dental considerations and management for head and neck cancer patients

Kufta, Kenneth; Forman, Michael; Swisher‐McClure, Samuel; Sollecito, Thomas P.; Panchal, Neeraj

doi:10.1016/j.oraloncology.2017.11.023

Cited by 37 publications

(22 citation statements)

References 108 publications

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“…Due to the loss of teeth and bone caused by prior extractions and ablative surgery, oral rehabilitation is often needed in HNC patients to regain oral function and oral aesthetics which are both important to improve QoL. The rehabilitation can be challenging because of the prior surgery, reconstruction and the side effects from the oncologic treatment, including mucositis, hyposalivation, xerostomia, fibrosis, trismus and osteoradionecrosis . The dental treatment after radiation therapy in the head and neck area has limitations since there is a risk of initiating osteoradionecrosis in the irradiated bone, and therefore extractions, surgery and insertion of dental implants are generally not recommended in this patient group after the radiation therapy has started …”

Section: Introductionmentioning

confidence: 99%

“…Currently, the literature of oral rehabilitation in HNC patients is mainly concerning the impact and side effects from radiation therapy and the usefulness of different rehabilitation methods, especially implants . Investigations in the field have shown that maxillofacial and oral rehabilitation are important ways to improve oral aesthetics, oral function and QoL after HNC treatment .…”

Section: Introductionmentioning

confidence: 99%

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Oral health‐related quality of life, oral aesthetics and oral function in head and neck cancer patients after oral rehabilitation

Fromm

Gotfredsen

Wessel

et al. 2019

J of Oral Rehabilitation

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Head and neck cancer (HNC) is diagnosed in more than 500 000 patients every year worldwide with increasing prevalence. Oral rehabilitation is often needed after HNC treatment to regain oral function, aesthetics and oral health‐related quality of life (OHRQoL). The objectives were to evaluate OHRQoL, oral aesthetics and oral function after oral rehabilitation in HNC patients and compare it to that of non‐HNC patients. Eighteen patients treated for HNC who subsequently had oral rehabilitation (2014‐2017), and a control group of eighteen age‐ and gender‐matched non‐HNC patients treated with removable prostheses (2014‐2018) were included in a cross‐sectional study. The OHRQoL was assessed by the Oral Health Impact Profile 49 questionnaire (OHIP‐49), the oral aesthetics by the Prosthetic Esthetic Index (PEI) and the Orofacial Esthetic Scale (OES), and the oral function by the Nordic Orofacial Test‐Screening (NOT‐S). The HNC patients had worse oral function and OHRQoL than the control patients (mean NOT‐S score 4.56 vs 0.56, P < 0.01 and mean OHIP‐49 score 42.50 vs 20.94, P = 0.050). When including number of replaced teeth and type of prosthesis in the tests, no significant difference in OHRQoL was found between the groups. No difference was found in the overall aesthetic outcomes (mean PEI total score 32.28 vs 30.67, P = 0.367 and mean OES total score 48.78 vs 53.56, P = 0.321). Multiple regression analyses showed that being HNC patient compared to control patient impaired the oral function. Oral function is significantly impaired in HNC patients compared to non‐HNC patients after oral rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral health‐related quality of life, oral aesthetics and oral function in head and neck cancer patients after oral rehabilitation

Fromm

Gotfredsen

Wessel

et al. 2019

J of Oral Rehabilitation

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“…Most studies have concluded that tooth extraction should be performed at least 7-21 days before RT. 8,[12][13][14][15][16] However, the wound-healing time should not be prolonged because this could compromise oncological treatment and prognosis. 13,[17][18][19][20] This study used 2000-2013 data from the Longitudinal Health Insurance Database for Catastrophic Illness Patients (LHID-CIP) of the Taiwan National Health Insurance (NHI) Administration to retrospectively analyse the ORNJ risk in patients with HNC who underwent tooth extraction 1-21 days before RT, with at least 12 months of follow-up.…”

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confidence: 99%

Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan

Liao

Chu

Tang

et al. 2020

Clinical Otolaryngology

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Head and neck cancer (HNC), representing 3% of all cancers, has been ranked as the sixth to eighth most common cancer type, with increasing global prevalence. 1 Despite advances in treatment, the mortality and morbidity rates remain high. 2 More than 70% of patients with HNC require radiotherapy (RT). 3,4 Oral complications (both acute and chronic effects) are common in patients receiving RT involving the oral cavity, including mucositis, infection, saliva change, fibrosis, sensory dysfunction, dental caries, periodontal disease and osteoradionecrosis. 5 Osteoradionecrosis, the most severe chronic complication, is difficult to treat clinically and is painful for patients. 6 Patients receiving head and neck RT should be dentally consulted before initial RT treatment to establish an appropriate oral

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“…Indeed, it was very difficult to spare some parts of jaws, mainly the posterior part of the mandible, without protecting a part of the tumor. 55 Today, with the IMRT, radiation oncologists can impose some dose constraints on the bone tissues, and algorithms can calculate dose distributions both to deliver adequate doses to the tumor and to follow the constraints on the critical organs without negative compromises. In the previously published studies, it was difficult to determine whether the reported doses were mean or maximum doses and whether these doses were those delivered in the place of implantation or the total mandible or maxilla.…”

Section: Discussionmentioning

confidence: 99%

Ability to Propose Optimal Prosthetic Rehabilitation can be Improved by Discussion between the Dentist and Radiation Oncologist Regarding Upstream Dosimetry

Rouers

Bornert

Truntzer³

et al. 2019

Eur J Dent

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Objective Improvement of dental rehabilitation for patients who have undergone radiation therapy requires knowledge of the dose in the maxillary and mandible bones. Materials and Methods Forty-three patients with head and neck cancers underwent evaluation for dental rehabilitation before radiation treatment dosimetry. The delivered dose to the maxilla and mandible was determined. From the dose data in the literature, three levels of risk of implant failure were defined. According to the delivered doses, the authors calculated the percentage of patients who could be fully rehabilitated with an implant, as proposed by the dentist before radiation planning. Results Before dosimetry calculation, all of the completely edentulous arches and 94 partially edentulous (PESs) sextants could be optimally rehabilitated. After dose calculation, among the 14 arches of 7 patients who were completely edentulous, according to the mean and maximal delivered doses, 11 arches (78.6%) and 7 arches (50%) could receive an optimal prosthesis, respectively. For the three patients, who were PESs but with one arch that was completely edentulous, according to the mean and maximal delivered doses, one arch for each dose condition could receive an optimal prosthesis. Among the 94 PESs sextants, according to the mean and maximal delivered doses, 41 (43.6%) and 24 (25.5%) sextants could receive an optimal prosthesis, respectively. Conclusion By determining the sites of implantation before dosimetry, the radiation oncologist could shield specified areas, potentially improving the possibilities for dental rehabilitation. The dialogue between the dentist and the radiation oncologist can improve the possibilities for implants and decrease the risk of unsafe implantation.

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Pre-Radiation dental considerations and management for head and neck cancer patients

Cited by 37 publications

References 108 publications

Oral health‐related quality of life, oral aesthetics and oral function in head and neck cancer patients after oral rehabilitation

Oral health‐related quality of life, oral aesthetics and oral function in head and neck cancer patients after oral rehabilitation

Preradiation tooth extraction and jaw osteoradionecrosis: Nationwide population‐based retrospective study in Taiwan

Ability to Propose Optimal Prosthetic Rehabilitation can be Improved by Discussion between the Dentist and Radiation Oncologist Regarding Upstream Dosimetry

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