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Journal of Cancer Research and... 2022The sequelae of head-and-neck radiation may include hyposalivation, dysgeusia, trismus, mucositis, and osteoradionecrosis. A mouthguard used during radiation therapy can...
The sequelae of head-and-neck radiation may include hyposalivation, dysgeusia, trismus, mucositis, and osteoradionecrosis. A mouthguard used during radiation therapy can mitigate the effects of backscatter radiation from dental restorations. In addition, an intraoral positioning stent can assist in repositioning oral structures, such as the tongue, away from the field of radiation during treatment, thereby limiting dose delivery. The purpose of this article is to provide a technique to fabricate a combination prosthesis, which functions to reposition oral structures as well as mitigate the effects of backscatter from dental restorations during head-and-neck radiation therapy.
Topics: Head and Neck Neoplasms; Humans; Osteoradionecrosis; Stents; Trismus; Xerostomia
PubMed: 36149177
DOI: 10.4103/jcrt.JCRT_825_19 -
Problemy Radiatsiinoi Medytsyny Ta... Dec 2020Odontological effects of ionizing radiation (IR) as a result of radiotherapy, the consequences of accidents at nuclear power plants and industry, individual occupational... (Review)
Review
BACKGROUND
Odontological effects of ionizing radiation (IR) as a result of radiotherapy, the consequences of accidents at nuclear power plants and industry, individual occupational exposure, etc. deserve significant attention interns of radiation medicine and radiation safety.
OBJECTIVE
to analyze and summarize clinical and experimental data on the odontological radiation effects.
OBJECT
the pathological changes in the hard tissues of teeth, pulp, periodontium, mucousmembranes of the mouth and jaws due to exposure to IR.
METHOD
search in the PubMed / MEDLINE, Google Scholarabstract medical and biological databases, scientific libraries of the relevant sources of scientific information.
RESULTS
Radiobiological effects of IR due to its direct and indirect action are manifested throughout the period ofodontogenesis and formation of the facial skeleton. Experimental and clinical data (in children and adults) indicatethe increased risk of dental caries, reduction of pain threshold and vascularization of tooth pulp along with its fibrosis and atrophy, periodontal dysfunction, which predispose to a high probability of tooth loss. Abnormalities in theactivity of osteoblasts and cementoblasts of dental periosteum and osteoblasts of alveolar process in combinationwith circulatory disorders due to endothelial cell death, hyalinization, thrombosis and vascular obliteration increasethe risk of jaw osteoradionecrosis. Children who have undergone a prenatal exposure to IR as a result of theChornobyl NPP accident have a premature change of teeth. Deterioration of periodontal tissues and early development of acute and complicated dental caries are typical for children and adults affected by the Chornobyl disaster.
CONCLUSIONS
Summarized data on the effects of radiation exposure under different conditions on teeth primordia(i.e. immature teeth), their formation and eruption in experimental and clinical settings, as well as on the odontological radiation effects in adults are summarized. Condition of the teeth in the Chornobyl NPP accident survivorsis described. Understanding and taking into account the radiobiological odontological effects is necessary in thelight of planning, preparing, and conducting local radiation therapy and developing the standards of radiation safety and measures to protect professionals and the public in the event of possible radiation accidents at the nuclearpower plants and industry facilities.
Topics: Chernobyl Nuclear Accident; Dental Caries; Dental Cementum; Dental Pulp; Endothelial Cells; Humans; Jaw; Mouth Mucosa; Odontogenesis; Osteoblasts; Osteoradionecrosis; Periodontium; Radiation Dosage; Radiation Exposure; Radiation Injuries; Radiation, Ionizing; Tooth; Tooth Loss
PubMed: 33361828
DOI: 10.33145/2304-8336-2020-25-18-55 -
JAMA Otolaryngology-- Head & Neck... Apr 2024
Topics: Humans; Osteoradionecrosis; Tooth Extraction; Mandible; Head and Neck Neoplasms
PubMed: 38358747
DOI: 10.1001/jamaoto.2023.4679 -
JAMA Otolaryngology-- Head & Neck... Apr 2024
Topics: Humans; Osteoradionecrosis; Tooth Extraction; Mandible; Head and Neck Neoplasms
PubMed: 38358736
DOI: 10.1001/jamaoto.2023.4680 -
The Journal of Craniofacial Surgery Sep 2017Osteoradionecrosis occurs in 4.74% to 37.5% of patients following radiation therapy for head and neck cancer. Osteoradionecrosis mostly happens in the mandible but...
Osteoradionecrosis occurs in 4.74% to 37.5% of patients following radiation therapy for head and neck cancer. Osteoradionecrosis mostly happens in the mandible but seldom occurs in other maxillofacial bones. Here, the authors reported a rare case of zygomatic osteoradionecrosis which occurred after maxillectomy and then radiotherapy because of maxillary myoepithelial carcinoma. After resection of zygoma sequestrum, the defect was repaired with forehead flap and healed uneventfully.
Topics: Aged; Humans; Male; Mandible; Maxilla; Maxillary Neoplasms; Osteoradionecrosis; Surgical Flaps; Zygoma
PubMed: 28708656
DOI: 10.1097/SCS.0000000000003890 -
British Dental Journal Aug 2020
Topics: Humans; Mandibular Diseases; Osteoradionecrosis; Surveys and Questionnaires
PubMed: 32811923
DOI: 10.1038/s41415-020-2020-x -
Current Oncology Reports Jul 2020This article aims to provide an update on literature data related to mandibular osteoradionecrosis (MORN) secondary to the irradiation of the head and neck region. (Review)
Review
PURPOSE OF REVIEW
This article aims to provide an update on literature data related to mandibular osteoradionecrosis (MORN) secondary to the irradiation of the head and neck region.
RECENT FINDINGS
Radiotherapy (RT) plays a crucial role in the contemporary management of head and neck cancer (HNC) patients and, despite intensity-modulated technique (IMRT), mandibular osteoradionecrosis (MORN) remains a significant RT-related complication. Based on its clinical manifestation, MORN can negatively affect patients' quality of life. Preventive interventions should be prioritized. This manuscript is expected to represent an opportunity to guide a clear proposal for clinical measures in the individual MORN situations.
Topics: Head and Neck Neoplasms; Humans; Mandible; Osteoradionecrosis; Quality of Life; Radiotherapy, Intensity-Modulated
PubMed: 32642937
DOI: 10.1007/s11912-020-00954-3 -
The Surgeon : Journal of the Royal... Apr 2015To review the conservative and surgical management options of osteoradionecrosis, in particular, highlighting the recent the use of anti-radiation fibrosis drugs... (Review)
Review
PURPOSE
To review the conservative and surgical management options of osteoradionecrosis, in particular, highlighting the recent the use of anti-radiation fibrosis drugs (pentoxifylline, tocopherol and clodronate).
MATERIAL AND METHODS
We performed a literature review. The management options were divided into two groups, conservative and surgical management.
RESULTS
Over the years several treatment options have been proposed including; conservative management (antibiotics, analgesics, oral hygiene), ultrasound therapy, hyperbaric oxygen therapy, surgical resection with reconstruction and more recently the use of anti-radiation fibrosis drugs (pentoxifylline, tocopherol and clodronate). Early or low grade ORN can be managed conservatively using a combination of treatment options. In advanced or refractory cases of ORN (pathological fracture, orocutaneous fistula) surgical treatment, at present, remains the only treatment option available. A new understanding of the pathophysiology of ORN (radiation induced fibroatrophic process) has lead to the development of new therapeutic management regimes.
CONCLUSION
In advanced or refractory cases of ORN surgical treatment, including microvascular reconstructive techniques for bone and soft tissue, remains the only option available.
Topics: Algorithms; Anti-Inflammatory Agents; Clodronic Acid; Fibrosis; Head and Neck Neoplasms; Humans; Hyperbaric Oxygenation; Jaw Diseases; Osteoradionecrosis; Pentoxifylline; Radiation-Protective Agents; Radiotherapy; Tocopherols
PubMed: 25084627
DOI: 10.1016/j.surge.2014.07.003 -
Journal of Oral and Maxillofacial... Jun 2022It is unclear whether certain bacteria initiate the development of inflammatory jaw conditions, or whether these diseases create a milieu for dysbiosis and secondary...
PURPOSE
It is unclear whether certain bacteria initiate the development of inflammatory jaw conditions, or whether these diseases create a milieu for dysbiosis and secondary colonization of indigenous flora. At present, there are no comparative studies on the types of bacteria that colonize different inflammatory jaw conditions. Accordingly, this study aims to identify and compare the types of bacteria isolated in osteomyelitis, osteoradionecrosis, and MRONJ.
METHODS
This is a retrospective cohort study of patients diagnosed with inflammatory jaw conditions. The predictor variables were classification of bacteria as oral flora, categorized herein as resident bacteria, non-resident bacteria, or opportunistic organisms. The outcome variables were a diagnosis of osteomyelitis, osteoradionecrosis, and MRONJ. Covariates were age, sex, penicillin allergy, a diagnosis of diabetes and a history of smoking. Data analysis was performed using ANOVA and chi-squared tests.
RESULTS
A total of 105 patients with inflammatory jaw conditions were enrolled. The final sample size was 69 subjects of which 16 were diagnosed with osteomyelitis, 20 with osteoradionecrosis, and 33 with MRONJ. There was no difference in the frequency that resident bacteria were isolated. Non-resident bacteria, which included Staphylococcus and Enterococcus among others, were isolated more frequently at 75% in osteomyelitis compared to 60% in osteoradionecrosis and 48% in MRONJ cases. There is weak evidence of significant difference when comparing osteomyelitis and MRONJ cases (P = .08). Opportunistic organisms, which included Mycobacterium and Candida, were isolated more frequently in osteoradionecrosis at 30% compared to 12.5% in osteomyelitis and 12.12% in MRONJ cases. There is weak evidence of significant difference when comparing osteoradionecrosis and MRONJ cases (P = .1).
CONCLUSION
Non-resident bacteria including Staphylococcus and Enterococcus may be more frequently isolated in patients with osteomyelitis, while opportunistic organisms like Mycobacterium and Candida may be more frequently found in patients diagnosed with osteoradionecrosis.
Topics: Bacteria; Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Candida; Humans; Jaw; Osteomyelitis; Osteoradionecrosis; Retrospective Studies
PubMed: 35405094
DOI: 10.1016/j.joms.2022.03.012 -
Head & Neck Jan 2017Preradiotherapy dental extractions often form a part of the management plan for patients treated with radiotherapy for head and neck cancers in order to prevent...
BACKGROUND
Preradiotherapy dental extractions often form a part of the management plan for patients treated with radiotherapy for head and neck cancers in order to prevent complications, such as osteoradionecrosis. There is contention about whether these extractions should be performed and the timing of such extractions. The purpose of this study was to determine if pre-RT extractions were associated with the development of osteoradionecrosis of the jaws.
METHODS
Retrospective data on patients treated with RT for oropharyngeal cancer were pooled with a cross-sectional survey.
RESULTS
Pre-radiotherapy dental extractions were associated with a statistically significant increase in the risk of developing ORN.
CONCLUSION
Pre-radiotherapy dental extractions do not protect against the development of osteoradionecrosis. © 2016 Wiley Periodicals, Inc. Head Neck 39: 128-132, 2017.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cross-Sectional Studies; Female; Humans; Male; Mandibular Diseases; Maxillary Diseases; Middle Aged; Oral Hygiene; Oropharyngeal Neoplasms; Osteoradionecrosis; Radiotherapy Dosage; Retrospective Studies; Tooth Extraction
PubMed: 27473832
DOI: 10.1002/hed.24553