ABSTRACT
The increase in the incidence of head and neck cancer has been accompanied by a more widespread use of chemotherapy. As a result, the dental community has frequent contact with patients who are undergoing or have undergone chemotherapy. In many of these patients, immunosuppression leads to an increased risk of infection, and the chemotherapeutic agents themselves can cause a variety of oral complications. The dentist must be familiar with available treatments for managing these conditions and for preventing further deterioration of oral and systemic health.
Subject(s)
Antineoplastic Agents/adverse effects , Dental Care for Chronically Ill , Bacterial Infections/drug therapy , Humans , Immunocompromised Host , Mouth Mucosa/drug effects , Mycoses/drug therapy , Neoplasms/drug therapy , Oral Hemorrhage/prevention & control , Periodontal Diseases/therapy , Stomatitis/chemically induced , Tooth Extraction , Virus Diseases/drug therapyABSTRACT
Chemotherapy is frequently used as a primary or adjunctive modality in the treatment of patients with cancer. As the incidence of cancer in the population increases, the ability to properly detect, diagnose, and treat oral side effects of chemotherapy becomes ever more important. Depending on the types and dosages of chemotherapeutic agents used, a wide range of oral complications may appear. This article, in two parts, reviews the potential oral manifestations associated with cancer chemotherapy and appropriate management techniques.
Subject(s)
Antineoplastic Agents/adverse effects , Dental Care for Chronically Ill , Mouth Diseases/chemically induced , HumansABSTRACT
As the incidence of head and neck cancer increases and the use of high-dose radiation treatment rises, the dentist will be called on to treat a wide variety of radiation-induced oral maladies. Treatment planning for radiotherapy patients begins immediately after tumor diagnosis and is directed first and foremost toward prevention of oral complications. In the event such complications occur, the dentist must be familiar with available treatment regimens for managing these conditions and preventing future deterioration in oral health.
Subject(s)
Cranial Irradiation/adverse effects , Dental Care for Chronically Ill/methods , Mouth Diseases/etiology , Dental Caries/etiology , Head and Neck Neoplasms/radiotherapy , Humans , Mouth Diseases/therapy , Mouth Mucosa/radiation effects , Osteoradionecrosis/etiology , Osteoradionecrosis/therapy , Patient Care Planning , Stomatitis/etiology , Stomatitis/therapy , Time Factors , Tooth Extraction , Xerostomia/complications , Xerostomia/etiology , Xerostomia/therapyABSTRACT
The incidence of head and neck cancer increases annually in the United States, and radiation therapy is frequently a primary or adjunctive mode of therapy. As the number of radiotherapy patients rises, the need for proper detection, diagnosis, and treatment of oral lesions likewise increases. Depending on tumor site and size, radiation dosage, and preexisting oral conditions, a variety of oral radiation side effects may be present. These range from mild and reversible changes to severe and potentially disfiguring or life-threatening alterations. This article, in two parts, will review the oral manifestations of cancer radiation therapy and appropriate management techniques.
Subject(s)
Cranial Irradiation/adverse effects , Mouth Diseases/etiology , Radiation Injuries/etiology , Head and Neck Neoplasms/radiotherapy , Humans , Mandible/radiation effects , Nutrition Disorders/etiology , Osteoradionecrosis/etiology , Periodontal Diseases/etiology , Taste Disorders/etiology , Xerostomia/etiologyABSTRACT
Surgical intervention into the maxillary posterior area can lead to inadvertent communication with the maxillary sinus. Spontaneous healing of 1 to 2 mm openings can occur. However, in patients with larger oroantral communications and those with a history of sinus disease, surgical closure is often indicated. Acute and chronic oroantral fistula and sinusitis can occur as a result of inadequate treatment. The most common causes of complications include inadequate site preparation, flap closure, flap necrosis, infection, and patient non-compliance. A technique for the closure of oroantral communications using guided tissue regeneration is described. This technique utilizes an absorbable gelatin film (membrane), allogenic bone graft material (DFDBA), and non-resorbable expanded polytetrafluoroethylene (ePTFE) membrane. The gelatin membrane prevents displacement of graft material into the antrum and sinus epithelial cell migration, while the ePTFE membrane promotes selective cell population with subsequent regeneration of the osseous wall of the oroantral defect.
