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Schroter GT, Stopiglia RMM, Carvalho GL, Morimoto S, Mota ME, Alves FA, Jaguar GC, Moreira MS. Osteoradionecrosis treatment in head and neck cancer patients: An overview of systematic reviews. SPECIAL CARE IN DENTISTRY 2024; 44:621-635. [PMID: 37534945 DOI: 10.1111/scd.12910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023]
Abstract
AIMS Evaluate the existing evidence of osteoradionecrosis (ORN) treatment in adults with head and neck cancer, the methodological quality and the evidence grade within systematic reviews (SRs). METHODS An extensive systematic literature search of SRs that addressed ORN in head and neck cancer patients was conducted with screening of eligible studies, data extraction, methodological (AMSTAR 2) and evidence quality assessment (GRADE) of the SRs by independent and calibrated authors. RESULTS A total of six SRs were enrolled. Based primarily on studies from the 1990s, there is critically low- or moderate-quality evidence that hyperbaric oxygen therapy (HBO) improves ORN healing. From 2005 onward, evidence has been discovered in relation to treatment with pentoxifylline and tocopherol (PENTO). The SRs indicate that the management of ORN with PENTO appears to be promising. The greatest rates of healing are seen in mild and moderate stages of ORN. However, the quality of evidence regarding PENTO, surgery and other treatments remains critically low. CONCLUSION There is no standardized protocol to treat ORN. PENTO appears to be the most promising conservative treatment; however, the current level of evidence regarding PENTO is still critically low. More robust clinical studies are needed to establish the best treatment for ORN.
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Affiliation(s)
| | | | | | - Susana Morimoto
- Postgraduate Program in Dentistry, Ibirapuera University, São Paulo, Brazil
| | - Maria Emília Mota
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Fábio Abreu Alves
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil
| | | | - Maria Stella Moreira
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
- Department of Stomatology, AC Camargo Cancer Center, São Paulo, Brazil
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Najafizade N, Mobini Dehkordi R, Hemati S. Investigating the effect of Aloe vera on the prevention and treatment of radiotherapy-induced oral mucositis in patients with head-and-neck cancer. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2024; 29:16. [PMID: 38808218 PMCID: PMC11132420 DOI: 10.4103/jrms.jrms_115_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/31/2023] [Accepted: 11/14/2023] [Indexed: 05/30/2024]
Abstract
Background Oral mucositis is one of the main complications of radiotherapy (RT) while treating head-and-neck cancers and can affect the patients' treatment process and life. Therefore, this study evaluated the effect of Aloe vera on the prevention and treatment of radiotherapy-induced oral mucositis (RIOM) in patients with head-and-neck cancer. Materials and Methods This was a double-blind clinical trial performed in 2019 on 75 patients with head-and-neck cancer. Patients were randomly assigned to two groups receiving gargles of 5 cc Aloe vera and the same dose of placebo mouthwash three times a day, respectively. Then, the incidence and severity of RIOM were evaluated and compared between the two groups over 6 weeks of RT. Results There was no significant difference between the two groups in terms of the severity of RIOM from the 1st to 3rd weeks of RT (P > 0.05). However, the severity of RIOM in the 4th, 5th, and 6th weeks of RT was significantly lower in the Aloe vera group compared with the placebo group (P < 0.05). Conclusion According to the results of the present study, the long-term use of Aloe vera mouthwash can reduce the severity of RIOM.
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Affiliation(s)
- Nadia Najafizade
- Department of Radiation Oncology, Cancer Prevention Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Mobini Dehkordi
- Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Simin Hemati
- Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Chen X, Zhang L, Lu H, Tan Y, Li B. Development and validation of a nomogram to predict cervical lymph node metastasis in head and neck squamous cell carcinoma. Front Oncol 2024; 13:1174457. [PMID: 38282669 PMCID: PMC10811551 DOI: 10.3389/fonc.2023.1174457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024] Open
Abstract
Background Head and neck cancers are a heterogeneous, aggressive, and genetically complex collection of malignancies of the oral cavity, nasopharynx, oropharynx, hypopharynx, larynx, paranasal sinuses and salivary glands, which are difficult to treat. Regional lymph nodes metastasis is a significant poor prognosis factor for head and neck squamous cell carcinoma. Metastasis to the regional lymph nodes reduces the 5-year survival rate by 50% compared with that of patients with early-stage disease. Accurate evaluation of cervical lymph node is a vital component in the overall treatment plan for patients with squamous cell carcinoma of the head and neck. However, current models are struggle to accurately to predict cervical lymph node metastasis. Here, we analyzed the clinical, imaging, and pathological data of 272 patients with HNSCC confirmed by postoperative pathology and sought to develop and validate a nomogram for prediction of lymph node metastasis in patients with head and neck squamous cell carcinoma. Methods We retrospectively analyzed the clinical, imaging, and pathological data of 272 patients with head and neck squamous cell carcinoma (HNSCC) confirmed by postoperative pathology at the Affiliated Hospital of Qingdao University from June 2017 to June 2021. Patients were randomly divided into the training and validation cohorts in a 3:1 ratio, and after screening risk factors by logistic regression, nomogram was developed for predicting lymph nodes metastasis, then the prediction model was verified by C-index, area under curve (AUC), and calibration curve. Results Of the 272 patients, seven variables were screened to establish the predictive model, including the differentiation degree of the tumor [95% confidence interval(CI):1.224~6.735, P=0.015], long-to-short axis ratio of the lymph nodes (95%CI: 0.019~0.217, P<0.001), uneven/circular enhancement (95%CI: 1.476~16.715, P=0.010), aggregation of lymph nodes (95%CI:1.373~10.849, P=0.010), inhomogeneous echo (95%CI: 1.337~23.389, P=0.018), unclear/absent medulla of lymph nodes (95%CI: 2.514~43.989, P=0.001), and rich blood flow (95%CI: 1.952~85.632, P=0.008). The C-index was 0.910, areas under the curve of training cohort and verification cohort were 0.953 and 0.938 respectively, indicating the discriminative ability of this nomogram. The calibration curve showed a favorable compliance between the prediction of the model and actual observations. The clinical decision curve showed this model is clinically useful and had better discriminative ability between 0.25 and 0.9 for the probability of cervical LNs metastasis. Conclusions We established a good prediction model for cervical lymph node metastasis in head and neck squamous cell carcinoma patients which can provide reference value and auxiliary diagnosis for clinicians in making neck management decisions of HNSCC patients.
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Affiliation(s)
- Xiaohan Chen
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lu Zhang
- Department of Radiation Oncology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haijun Lu
- Department of Oncology and Radiotherapy, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ye Tan
- Department of Oncology and Radiotherapy, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bo Li
- Department of Oncology and Radiotherapy, Affiliated Hospital of Qingdao University, Qingdao, China
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Brandt E, Keskin M, Räisänen IT, Mäkitie A, Pätilä T, Sorsa T, Gupta S. Periodontal Disease - A Late Complication of Head and Neck Cancer Radiotherapy. Cancer Control 2024; 31:10732748241255845. [PMID: 38760005 PMCID: PMC11102687 DOI: 10.1177/10732748241255845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/21/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024] Open
Affiliation(s)
- Ella Brandt
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mutlu Keskin
- Oral and Dental Health Department, Altinbas University, Istanbul, Turkey
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology- Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tommi Pätilä
- Division of Pediatric Surgery, Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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Nazari AM, Zare-Kaseb A, Arbabi Z, Gholampour MH, Emami Zeydi A, Ghazanfari MJ. The effect of Benson relaxation technique on cancer patients: a systematic review. Support Care Cancer 2023; 31:681. [PMID: 37938356 DOI: 10.1007/s00520-023-08142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Although many studies have investigated the effect of this method on cancer patients, no review of the available literature has been done. So, a literature review is conducted to evaluate all published literature on the Benson relaxation technique in cancer patients. METHODS A systematic literature search was conducted. A systematic search of online electronic databases including PubMed/MEDLINE, Scopus Web of Science, PsycINFO, and EMBASE was performed using keywords extracted from Medical Subject Headings such as "Benson Relaxation Technique," "Cancer Patients," "Malignancy," and "Neoplasia" from the beginning to April 27, 2023. A total of 810 publications were assessed for relevance by title and abstract. The remaining 31 articles were examined using inclusion criteria for all Persian and English-language publications that evaluate the effectiveness of the Benson relaxation technique on cancer patients. We did not have gray literature in our review. The methodological quality of the included studies was appraised using specific checklists. RESULTS Finally, nine studies were included in this systematic review. Studies on breast cancer patients showed improvement in fatigue, nausea, vomiting, pain, shortness of breath, insomnia, anorexia, constipation, diarrhea, treatment side effects, breast symptoms, arm symptoms, worry about hair loss, and scores of hope. Two studies were conducted among cervical cancer patients that showed a decrease in anxiety scores and an improvement in the quality of sleep. Another study on gastric cancer patients showed decreased Chemotherapy-Induced Nausea, Vomiting, and Retching scores. CONCLUSION Overall, this systematic review showed that the Benson relaxation method could improve sleep quality, appetite, anxiety, and quality of life. Therefore, using the Benson relaxation technique is suggested to improve health-related outcomes in cancer patients.
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Affiliation(s)
- Amir Mohamad Nazari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akbar Zare-Kaseb
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Arbabi
- Master of Sciences in Medical-Surgical Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Hashem Gholampour
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Abed H. Dental considerations for head and neck cancer: A clinical review. Saudi Dent J 2023; 35:476-486. [PMID: 37520601 PMCID: PMC10373080 DOI: 10.1016/j.sdentj.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Radiotherapy is one of the treatment modalities for the treatment of head and neck cancer (HNC). However, it leads to the development of chronic and acute side effects. These side effects impact negatively on the patient's quality of life and oral functioning. This clinical review aims to provide basic information about HNC, understand the impact of radiotherapy on oral health, and explain the role of dental care providers for HNC patients during the pre-and post-radiotherapy time. Materials and Methods Electronic databases (i.e., PubMed, Scopus, and Google Scholar) were searched using defined keywords. The main inclusion criteria were any studies describing "dental management of patients with head and neck cancer" and "dental management of patients treated with radiotherapy." Results Thematic analysis was used to summaries the findings of the included studies (n = 102) into main headings and subheadings. All studies were published between 1970 and 2023. Conclusion The number of HNC patients is increasing. This necessitates the need for raising the awareness of dental care providers to the side-effects of HNC therapy which includes treatment with radiotherapy, chemotherapy, and/or surgery. Dental care providers should understand the common side-effects and their treatments besides their role in the pre- (i.e., dental extraction of teeth with poor prognosis and maintaining good oral hygiene) and post- (i.e., oral rehabilitation and post-HNC dental care) radiotherapy dental care.
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Bhandari S, Wadhwa Soni B, Gupta A, Ghoshal S. Time required for prophylactic oral care in head and neck cancer patients scheduled for radiotherapy: A single center, prospective cohort study. Head Neck 2023; 45:913-920. [PMID: 36794635 DOI: 10.1002/hed.27317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/21/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Prophylactic oral care (POC) before radiotherapy (RT) is an adjunct but an integral process toward preparing patients for RT, however, time to be invested in POC remains unexplored. METHODS Prospective treatment records were maintained in head and neck cancer patients, who received POC following a standardized protocol with definite timelines. Data collected for oral treatment time (OTT), interruption in RT due to oro-dental issues, future extraction(s), and incidence of osteoradionecrosis (ORN) up to 18 months after treatment were analyzed. RESULTS Three hundred thirty-three patients, 275 males and 58 females, mean age 52.45 ± 11.2 years were included. Mean OTT was 21.0 ± 6.2 days and was influenced significantly with the number of extractions (p < 0.00). There was no interruption in RT schedule due to oro-dental issues. Five patients were diagnosed with ORN. CONCLUSION Performing POC as demonstrated aid in timely removal of nidus of infection(s), perform RT as scheduled, and maintain satisfactory oral health through the survivorship of patients.
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Affiliation(s)
- Sudhir Bhandari
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhavita Wadhwa Soni
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankita Gupta
- Department of Radiation Oncology, Advanced Centre for Treatment, Research, and Education in Cancer, Tata Memorial Centre, HBNI, Navi Mumbai, India
| | - Sushmita Ghoshal
- Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abed H, Reilly D, Burke M, Sharka R, Daly B. The association between dental arch length and oral health-related quality of life in head and neck cancer patients post-radiotherapy. SPECIAL CARE IN DENTISTRY 2023; 43:111-118. [PMID: 35830628 DOI: 10.1111/scd.12755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/13/2022] [Accepted: 06/27/2022] [Indexed: 12/27/2022]
Abstract
AIMS To assess the association between length of dental arch and oral health-related quality of life in head and neck cancer patients post-radiotherapy. METHODS Thirty head and neck cancer participants reported their oral health-related quality of life using the oral health impact profile-14 instrument and their global self-rating of general and oral health. All patients had received chemotherapy and radiotherapy. The length of dental arch was assessed in three tooth relational categories: canine-to-canine, shortened (premolars to premolars), and long (molars to molars) dental arches. Inclusion of participants for any of the three categories required verification of opposing teeth relationship with Shim Stock paper. RESULTS Out of 30 head and neck cancer patients, eight (27%) had a canine-to-canine dental arch, 14 (46%) had a shortened dental arch, and eight (27%) had a long dental arch. The median oral health impact profile-14 scores for participants respectively with the canine-to-canine dental arch was six (IQR = 9.25), seven (IQR = 8) for participants with shortened dental arch, and 11 (IQR = 12.5) for participants with long dental arch. There were no significant differences in oral health impact profile-14 scores between the three-tooth relational groups (Kruskal-Wallis H = 0.769, df = 2, P-value = .681). Similarly, there were no significant differences between three-tooth relational groups on the self rating of general (Chi-squared = 1.714, df = 2, P-value = .424) and oral health (Chi-squared = 1.393, df = 2, P-value = .498). CONCLUSION Within the limitations of this study, no association was found between the length of dental arch and oral health-related quality of life in head and neck cancer patients post-radiotherapy. Other factors such as dry mouth, oral mucositis, loss of taste, and trismus should be considered as contributory factors to reduced oral health-related quality of life in head and neck cancer patients post-radiotherapy, particularly in relation to eating difficulties.
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Affiliation(s)
- Hassan Abed
- Department of Baisc and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Damien Reilly
- Department of Special Care Dentistry, Surrey and Sussex Healthcare NHS Trust, Redhill, Surrey, UK
| | - Mary Burke
- Department of Sedation and Special Care Dentistry, Guys and St Thomas' NHS, Foundation Trust, London, UK
| | - Rayan Sharka
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Blánaid Daly
- School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Dublin, Ireland
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Abed H. National and international guidelines on the replacement of missing teeth with dentures for head and neck cancer patients post-radiotherapy: A rapid review. Saudi Dent J 2023; 35:125-132. [PMID: 36942203 PMCID: PMC10024079 DOI: 10.1016/j.sdentj.2023.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Background Replacement of missing teeth is not a straightforward task in head and neck cancer (HNC) patients post-radiotherapy. There is debate regarding the best way to care for these patients as it has been reported that using dentures by HNC patients after receiving treatment with radiotherapy might initiate the development of osteoradionecrosis. Aim This rapid review aimed to collate and compare the national and international guidelines for the use of dentures following radiotherapy for HNC patients. Materials and methods Three steps were included in data collection of this rapid review (first step; identification of dental and relevant non-dental associations/societies, second step, identification of national and international guidelines regarding the dental management of HNC patients, and third step; identification of recommendations about the replacement of missing teeth in HNC patients). Results In the 193 countries recognized by the United Nations, there were 238 relevant societies found, from those 175 confirmed that they do not have clear guidelines. Only 32 associations/societies (all in either Europe and North America) recommend guidelines for their dentists (N = 12 guidelines) about the dental management of HNC patients and show their position regarding the use of dentures for HNC patients after receiving treatment with radiotherapy. Conclusions There are very few guidelines and those that do exist differ, lack detail, and rarely go beyond routine advice. Accordingly, clear, detailed, and evidence-based guidelines are required to inform the management of patients with missing teeth following radiotherapy for HNC patients.
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Key Words
- ACS, American Cancer Society
- BAHNO, British Association of Head and Neck Oncologists
- BSDH, The British Society for Disability and Oral Health
- Dentures
- ENT-UK, The British Association of Otorhinolaryngology
- EPRT, External beam radiotherapy
- HNC, Head and neck cancer
- Head and neck neoplasm
- MCF, Mouth Cancer Foundation
- MDT, Multidisciplinary Team
- N/R, Not reported
- NCI, National Cancer Institute
- NIDCR, National Institute of Dental and Craniofacial Research
- OCF, Oral Cancer Foundation
- ORN, Osteoradionecrosis
- Osteoradionecrosis
- QoL, Quality of life
- RCS, Royal College of Surgeons
- Radiotherapy
- UF, University of Florida
- UK, United Kingdom
- US, United States
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Zhao M, Ji C, Dai H, Wang C, Liu R, Xie J, Wang Y, Gu Z. Mussel-Inspired Tantalum Nanocomposite Hydrogels for In Situ Oral Cancer Treatment. ACS APPLIED MATERIALS & INTERFACES 2023; 15:4984-4995. [PMID: 36649169 DOI: 10.1021/acsami.2c20467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Oral squamous cell carcinoma (OSCC) is one of the most common oral malignancies. Radiotherapy is the primary noninvasive treatment of OSCC for avoiding surgery-induced facial deformities and impaired oral function. However, the specificity of in situ OSCC limits radiotherapeutic effects because of the hypoxia-induced low radiosensitivity of tumors and the low radiation tolerance of surrounding normal tissues. Here, we design a highly efficient and low-toxic radiosensitization strategy. On the one hand, biocompatible poly(vinyl pyrrolidone)-modified tantalum nanoparticles (Ta@PVP NPs) not only have strong X-ray deposition capability to upregulate oxidative stress but also have photothermal conversion efficiency to improve hypoxia for tumor radiosensitivity. On the other hand, to optimize the spatial distribution of Ta@PVP NPs within tumors, mussel-inspired catechol with bioadhesive properties is grafted on tumor microenvironment-responsive sodium alginate (DAA) to form in situ hydrogels for precision radiotherapy. On this basis, we find that Ta@PVP-DAA hydrogels effectively inhibit OSCC development in mice under photothermal-assisted radiotherapy without facial deformities and damage to surrounding normal tissues. Overall, our work not only promotes the exploration of Ta@PVP NPs as new radiosensitizers for OSCC but also develops a nanocomposite hydrogel system strategy as a promising paradigm for the precision treatment of orthotopic tumors.
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Affiliation(s)
- Maoru Zhao
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing 100049, China
- Center of Materials Science and Optoelectronics Engineering, College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chao Ji
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing 100049, China
| | - Hao Dai
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Chengyan Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing 100049, China
| | - Ruixue Liu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing 100049, China
| | - Jiani Xie
- School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China
| | - Yuguang Wang
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhanjun Gu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing 100049, China
- Center of Materials Science and Optoelectronics Engineering, College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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Unforeseen Outcomes Post Treatment for Radiation Induced Trismus: A Case Report. MEDICINES 2022; 9:medicines9050031. [PMID: 35622070 PMCID: PMC9147736 DOI: 10.3390/medicines9050031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022]
Abstract
Post radiotherapy radiation trismus presents significant concerns for a patient’s quality of life and for the clinical monitoring for recurrence of head and neck oncology. Current treatments include scar band release surgery that has been shown to be safe and effective. We present a case with a rare, post-operative complication of difficulty of mouth closure that can pose a significant impact on quality of life that should be considered.
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Jain R, Ghosh M, Goel R, Gupta R, Golhait P, Ghosh B. A challenging journey of maxillofacial implants placement and rehabilitation in an irradiated exenterated socket. J Oral Biol Craniofac Res 2022; 12:319-323. [DOI: 10.1016/j.jobcr.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/02/2021] [Accepted: 03/18/2022] [Indexed: 10/18/2022] Open
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Chemical analysis of irradiated root dentin and its interaction with resin cements. Clin Oral Investig 2022; 26:4315-4325. [PMID: 35149905 DOI: 10.1007/s00784-022-04395-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate the chemical changes in root dentin submitted to ionizing radiation and how it affects the interaction with resin cements. MATERIALS AND METHODS Forty human premolars were randomly divided into two groups (n = 20): non-irradiated and irradiated. They were randomly subdivided according to the type of resin cement (n = 10): conventional (RelyX ARC, 3 M ESPE) or self-adhesive (RelyX U200, 3 M ESPE). After cementation of the fiberglass posts, the roots were sectioned to be analyzed by Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, and confocal laser scanning microscopy (CLSM). The data obtained from FTIR and Raman were analyzed using two-way ANOVA followed Tukey's test (α = 0.05). For CLSM, a descriptive analysis was performed. RESULTS In the FTIR, there was a significant difference between the non-irradiated and irradiated groups for phosphate (p = 0.011), carbonate (p < 0.001), amide III (p = 0.038), and carbonate/mineral ratio (p < 0.001). Regarding the root third, there was a difference for amide I (p = 0.002), mineral/matrix ratio (p = 0.001), and amide I/CH2 (p = 0.026) between the cervical and the others. Raman spectroscopy revealed no difference between groups for 961/1458 cm-1 in the diffusion zone. CLSM showed a different interaction pattern for the two cements with the irradiated dentin from the cervical third. CONCLUSIONS Ionizing radiation altered the chemical composition of root dentin, especially in the cervical third. The resin cements showed less interaction with the irradiated root dentin. CLINICAL RELEVANCE As radiotherapy alters the chemical composition of root dentin, the interaction of resin cement with dentin can compromise the success of rehabilitation with fiberglass posts.
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Abed H, Burke M, Fenlon MR, Scambler S, Scott SE. Dentists' perspectives on denture provision after radiotherapy for head and neck cancer: an exploratory study using the theoretical domains framework. Br Dent J 2021:10.1038/s41415-021-3668-6. [PMID: 34887552 DOI: 10.1038/s41415-021-3668-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/24/2021] [Indexed: 11/09/2022]
Abstract
Introduction Patients are often keen to replace their missing teeth after radiotherapy for head and neck cancer (HNC), yet such replacement does not always take place.Aims This study aimed to investigate the influences on dentists' provision of dentures for patients treated with radiotherapy for HNC, including whether risk of osteoradionecrosis (ORN) is a factor influencing intention to provide dentures.Methods An online cross-sectional survey including a case scenario, self-reported behaviour and measures of factors (selected using the theoretical domains framework) that may affect dentists' decisions was completed by general dental practitioners (n = 150) and HNC multidisciplinary team dentists (n = 25) in England.Results Dentists' reluctance to provide dentures for HNC patients post-radiotherapy was often due to concerns about dry mouth and radiation caries rather than risk of ORN. Knowledge of guidelines and beliefs about consequences were independently associated with dentists' intention to replace missing teeth with dentures.Conclusion The likelihood of replacing missing teeth with dentures increased with awareness of clinical guidance on the use of dentures in HNC and that denture provision would have positive consequences that outweigh the costs.
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Affiliation(s)
- Hassan Abed
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.
| | - Mary Burke
- Department of Sedation and Special Care Dentistry, Guy´s and St Thomas´ Foundation Trust, London, UK
| | - Michael R Fenlon
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK
| | - Sasha Scambler
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK
| | - Suzanne E Scott
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK
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Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis. J Clin Med 2021; 10:jcm10204696. [PMID: 34682818 PMCID: PMC8539984 DOI: 10.3390/jcm10204696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022] Open
Abstract
The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen's d 0.15; 95% CI: -0.25 to 0.54; I2 45.87%; p heterogeneity = 0.10). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.
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Dosimetric Parameters Predicting Tooth Loss after Carbon Ion Radiotherapy for Head and Neck Tumors. RADIATION 2021. [DOI: 10.3390/radiation1030017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Tooth loss reduces quality of life; however, little is known about tooth loss caused by carbon ion radiotherapy (CIRT). Here, we aimed to elucidate the incidence of tooth loss post-CIRT for head and neck tumors and to identify risk-predictive dosimetric parameters. Methods: This study enrolled 14 patients (i.e., 171 teeth in total) with head and neck non-squamous cell carcinoma. All patients received CIRT comprised of 57.6 or 64.0 Gy (relative biological effectiveness, RBE) in 16 fractions. Dose–volume analysis of the teeth was performed using receiver operating characteristic (ROC) curve analysis with VX (i.e., the volume irradiated with X Gy (RBE)). Results: The median follow-up period was 69.1 months. The median time of tooth loss was 38.6 months. The 5 year cumulative incidence of tooth loss was 13.3%. The volume of irradiated teeth was significantly greater for the lost teeth than for the remaining teeth throughout the dose range. Using the cut-offs calculated from ROC curve analysis, V30–V60 showed high accuracy (i.e., >94%) for predicting tooth loss, with V50 being the most accurate (cut-off, 58.1%; accuracy, 0.95). Conclusions: This is the first report to examine the incidence of tooth loss post-CIRT and to identify risk-predictive dosimetric parameters.
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Bhandari S, Soni BW, Ghoshal S. Impact of non-compliance with oral care on radiation caries in head and neck cancer survivors. Support Care Cancer 2021; 29:4783-4790. [PMID: 33527227 DOI: 10.1007/s00520-021-06033-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/26/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE A cross-sectional study was performed to quantify radiation caries (RC); explore the possible influence of various covariates like elapsed time since radiotherapy, cancer site and stage, treatment modality(ies), grades of xerostomia (GOX), and inter-incisal mouth opening on RC; and also to estimate the unmet treatment needs in head and neck cancer (HNC) survivors, where personal and professional oral care was neglected before and after completion of the treatment. METHODOLOGY Clinical status of the dentition was recorded using decayed missing filled surface/decayed missing filled teeth (DMFS/DMFT) index. Patients were grouped according to the respective covariates, and relevant statistical analysis was performed considering p value ≤ 0.05 as statistically significant. RESULTS Eighty nine patients, 72 males and 17 females, with a mean age of 52.37±11.19 (range 18-70) years were included in this study. Overall, 85% (76/89) and 78% (29/37), 87.5% (35/40), and 100% (12/12) of patients reporting within 1, 1-3, and 3-5 years after RT, respectively, were affected with RC. The mean DMFS/DMFT score, range, and standard deviation in the included patients up to 5 years post-RT were 61.12/15.99, 0-128/0-28, and 36.608/8.66, respectively. Unmet treatment needs concerning dental decay were 97%. A statistically significant difference was found between the mean DMFS with elapsed time since radiotherapy and different GOX, respectively. CONCLUSION Oral health will be worse, treatment needs will be high, and limitations to performing desirable treatment will be numerous in HNC patients, where the oral care component of their treatment is ignored. Future studies are required to identify the true relationship between various risk factors and the development and progression of RC.
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Affiliation(s)
- Sudhir Bhandari
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Bhavita Wadhwa Soni
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushmita Ghoshal
- Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Ezzat YE, Sharka RM, Huzaimi AA, Al-Zahrani KM, Abed HH. The role of exercise therapy in managing post-radiotherapy trismus in head and neck cancer. J Taibah Univ Med Sci 2021; 16:127-133. [PMID: 33603641 PMCID: PMC7858014 DOI: 10.1016/j.jtumed.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/11/2020] [Accepted: 07/14/2020] [Indexed: 01/07/2023] Open
Abstract
Trismus is a post-radiotherapy complication that affects survivors of head and neck cancers. It is described as the reduction of mouth opening to less than 35 mm. The condition is a progressive process; hence early intervention is crucial to prevent further damage and weakness to the elevator muscles of the mandible. Here, we report a 40-year-old woman with known squamous cell carcinoma of the maxillary sinus in stage T3N0M0 who had undergone upper right partial maxillectomy with subsequent 33 fractions of radiotherapy (66 Gy; intensity-modulating radiotherapy). Five months post-radiotherapy, the patient showed interest in replacing her missing teeth to restore her oral functions and facial appearance. At her post-radiotherapy visit in the dental assessment clinic, she showed a mouth opening of 12 mm. The TheraBite® Jaw Motion Rehabilitation System™ and wooden tongue depressors were alternatively used for 6 weeks (4-5 stretches/day; each stretch held for 15 s). Mouth opening gradually increased to 20 mm. Consequently, a definitive obturator prosthesis was fabricated using computer-aided design and computer-aided manufacturing technologies with the 3Shape D900 model scanner. These were challenging and time-consuming steps, but acceptable facial appearance and mouth opening were restored for the patient. This case suggests that Therabite® Jaw Motion Rehabilitation SystemTM and wooden tongue depressors help to increase mouth opening significantly if used together and alternatively.
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Affiliation(s)
- Yousef E. Ezzat
- Department of Prosthodontic, College of Dentistry, Riyadh Elm University, Riyadh, KSA
- Yanbu Dental Center, General Directorate of Health Affairs of Almadinah Almunawwarah, Ministry of Health, Yanbu, KSA
| | - Rayan M. Sharka
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Umm Alqura University, Makkah, KSA
| | - Adel A. Huzaimi
- Department of Prosthodontic, College of Dentistry, Riyadh Elm University, Riyadh, KSA
- King Fahad Medical City, Department of Maxillofacial Surgery and Rehabilitation, Riyadh, KSA
| | - Khaled M. Al-Zahrani
- Department of Prosthetic Dental Science, Prince Sattam Bin Abdulaziz University, Al-Kharj, KSA
| | - Hassan H. Abed
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Alqura University, Makkah, KSA
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Effects of fractionation and ionizing radiation dose on the chemical composition and microhardness of enamel. Arch Oral Biol 2020; 121:104959. [PMID: 33171393 DOI: 10.1016/j.archoralbio.2020.104959] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/17/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the chemical and mechanical properties of enamel submitted to different in vitro radiation protocols. DESIGN Third molars were divided into seven groups (n = 8): non-irradiated (NI); a single dose of 30 Gy (SD30), 50 Gy (SD50), or 70 Gy (SD70) of radiation; or fractional radiation doses of up to 30 Gy (FD30), 50 Gy (FD50), or 70 Gy (FD70). Hemisections were analysed by Fourier transform infrared spectroscopy (FTIR), energy dispersive X-ray spectroscopy (EDS) and Knoop microhardness (KHN) test. One-way ANOVA followed by Bonferroni's post-hoc test compared the test groups with the NI. Two-way ANOVA was performed for the fractionation and radiation dose, followed by Bonferroni's test (α = 0.05). RESULTS FTIR revealed differences for the amide I band between the NI and FD50 and NI and FD70 groups (p < 0.001). For the organic matrix/mineral ratio, the FD70 group presented a lower ratio compared to NI (p = 0.009). Excluding the NI group, there were differences between the FD30 and FD50 (p = 0.045) and the FD30 and FD70 groups (p < 0.001). For EDS, there were differences for Ca (p = 0.011) and Ca/P (p < 0.001), with the FD70 group presenting lower values compared to NI (p = 0.015; p < 0.001). For KHN, the FD70 group presented lower values than the NI (p = 0.002). Two-way ANOVA showed difference for the dose (p < 0.001), with the 70 Gy group presenting a lower KHN value within the fractionated groups. CONCLUSION Fractional doses 70 Gy irradiation caused chemical and mechanical changes to enamel. Radiation applied in single or fractional doses produced different effects to enamel.
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Miranda RRD, Lopes CDCA, Franco NMAS, Cabral LC, Simamoto JÚnior PC, Novais VR. Head and neck cancer therapy-related oral manifestation management in the COVID-19 pandemic: a critical review. Braz Oral Res 2020; 34:e120. [PMID: 33146316 DOI: 10.1590/1807-3107bor-2020.vol34.0120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/04/2020] [Indexed: 12/23/2022] Open
Abstract
With the onset of the new coronavirus disease (COVID-19) pandemic, the dental treatment of patients at risk of infection has become quite challenging. In view of this, patients with head and neck cancer may present with oral complications due to anticancer therapy, making dental assistance necessary. Thus, the objective of the study was to review the literature and critically discuss important concerns about the treatment of patients with head and neck cancer during the COVID-19 pandemic. Because dental professionals are in close contact with the main viral transmission routes, this study presents recommendations for management and protection during clinical dental care. The main characteristics and transmission routes of COVID-19 are also discussed. Dental professionals should control pain and the side effects of antineoplastic treatment and use preventive measures for infection control. During this pandemic, patients with head and neck cancer should not undergo elective procedures, even if they do not have symptoms or a history of COVID-19; therefore, in asymptomatic or painless cases, only preventive actions are recommended. In symptomatic or painful cases, precautions for safe interventional treatments must be implemented by following the hygiene measures recommended by health agencies and using personal protective equipment. During health crises, new protocols emerge for cancer treatment, and professionals must act with greater attention toward biosafety and updated knowledge. It is important to offer adequate individualized treatment based on the recommendations of preventative and interventional treatments so that patients can face this difficult period with optimized quality of life.
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Affiliation(s)
- Rafael Resende de Miranda
- Universidade Federal de Uberlândia - UFU, School of Dentistry , Department of Operative Dentistry and Dental Materials , Uberlândia , MG , Brazil
| | - Camila de Carvalho Almança Lopes
- Universidade Federal de Uberlândia - UFU, School of Dentistry , Department of Removable Prosthodontics and Dental Materials , Uberlândia , MG , Brazil
| | | | - Luana Cardoso Cabral
- Faculdade Morgana Potrich - FAMP, School of Dentistry , Department of Oclusion, Fixed Prosthesis and Dental Materials , Mineiros , GO , Brazil
| | - Paulo Cézar Simamoto JÚnior
- Universidade Federal de Uberlândia - UFU, School of Dentistry , Department of Oclusion, Fixed Prosthesis and Dental Materials , Uberlândia , MG , Brazil
| | - Veridiana Resende Novais
- Universidade Federal de Uberlândia - UFU, School of Dentistry , Department of Operative Dentistry and Dental Materials , Uberlândia , MG , Brazil
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Abed H, Burke M, Fenlon MR, Scambler S, Scott SE. Use of dentures, receipt of information, quality of life, and oral function following radiotherapy for head and neck cancer. SPECIAL CARE IN DENTISTRY 2020; 40:475-487. [PMID: 32777100 DOI: 10.1111/scd.12505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/02/2020] [Accepted: 07/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Teeth with a poor prognosis are often extracted prior to radiotherapy for head and neck cancer (HNC) in order to help prevent the need for dental treatment after radiotherapy that might in turn lead to the development of osteoradionecrosis. However, the details and impact of replacing missing teeth after radiotherapy for HNC have received little attention, especially from the patients' perspective. AIMS This study aimed to assess the use, satisfaction, and impact of denture use following radiotherapy for HNC. The study also sought to determine patients' satisfaction with information about replacing their missing teeth postradiotherapy. Finally, this study also aimed to assess interest in replacing missing teeth for those who had not done so. METHODS A structured, validated, and reliable questionnaire was sent to HNC patients who had received radiotherapy and had missing teeth at the time of discharge. In addition to demographic details and self-reported oral hygiene, the questionnaire included questions on use of (or interest in) dentures, satisfaction with dentures, satisfaction with information about replacing missing teeth, QoL as measured by two questions from the short version of WHOQoL-BREF, and oral functioning as measured by BCSQ-H&N. Demographic details and clinical details were extracted from the hospital records. RESULTS N = 80 (24%) returned a completed questionnaire. Participants had an average of 12 missing teeth (SD = 8.05). Most (n = 60, 75%) had not replaced their missing teeth. Of these, 35 (58%) were very or extremely interested in doing so. For HNC survivors who wore dentures, there was variable satisfaction and a number of side-effects of wearing dentures. Satisfaction with information about replacing missing teeth was low. There was no statistical difference in QoL or oral functioning between participants who wore dentures and participants who did not wear dentures. However, those with dentures reported fewer problems with carrying out daily routines as measured by the oral functioning tool. CONCLUSIONS QoL and oral functioning were similar regardless of denture use, highlighting reduced oral function in both those with and without dentures. In those who had not replaced their missing teeth, there was substantial interest in doing so and thus may be an unmet need. The dental team could offer HNC survivors more support after radiotherapy and following denture provision to improve information about denture use and increase satisfaction with dentures.
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Affiliation(s)
- Hassan Abed
- Faculty of Dentistry, Oral and Craniofacial Sciences King's College London, London, UK.,Faculty of Dentistry, Department of Basic and Clinical Oral Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.,Department of Sedation and Special Care Dentistry, Guy's & St Thomas' Foundation Trust, London, UK
| | - Mary Burke
- Department of Sedation and Special Care Dentistry, Guy's & St Thomas' Foundation Trust, London, UK
| | - Michael R Fenlon
- Faculty of Dentistry, Oral and Craniofacial Sciences King's College London, London, UK
| | - Sasha Scambler
- Faculty of Dentistry, Oral and Craniofacial Sciences King's College London, London, UK
| | - Suzanne E Scott
- Faculty of Dentistry, Oral and Craniofacial Sciences King's College London, London, UK
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