Effectiveness of dental treatments before irradiation in head and neck cancer patient: a retrospective cohort study
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Abstract
Dental treatments before radiation therapy in patients with head and neck cancer reduce the risk of complications that may affect their quality of life. The objective of the study was to study the effectiveness of dental treatment before radiation in patients with head and neck cancer, aimed to examine the following; rate of postradiation tooth extraction, incidence of osteoradionecrosis (ORN), rate of radiation caries, follow-up compliance rate, and related factors. This was the retrospective cohort study that examined the relationship between factors using medical records from 2012 to 2021 in patients with head and neck cancer. The statistics used included descriptive statistics, assessing the relationship between factors using chi-square or Fisher’s exact test, odds ratio (95% CI) and analyzing logistic regression at a significance level of 0.05. For the results, the population of 156 patients underwent tooth extraction before radiation, with 96.2% receiving extractions. Following that, 30.8% underwent scaling, and 13.5% received fillings. Additionally, 35.3% of patients had full mouth (FM) extractions. The study found that the rate of dental caries occurrence after radiation was 28.7%. Factors related to oral health, radiation dosage, and fluoride application showed no statistically significant relationship with the occurrence of dental caries. The rate of postradiation tooth extraction was 17.8%, the follow-up compliance rate was 65.4%, the average follow-up period was 1.95 years. The incidence of osteoradionecrosis of the jaw was 9.00%, the study found that patients who underwent alveoloplasty after radiation had a 5.70 times greater chance of developing osteoradionecrosis of the jaw compared to those who did not have alveoloplasty (adjusted OR = 5.70, 95% CI: 1.10-29.5), which was statistically significant (p = 0.04) after controlling for the influence of tooth extractions performed less than 14 days and 21 days before radiation, FM extractions before radiation, and chemotherapy. For conclusion, the contributing factor leading to ORN was alveoloplasty after radiation. It may be suggested that the effectiveness of oral preparation before radiation is still inadequate, as there is a need for aveoloplasty later, which can lead to the occurrence of osteoradionecrosis.
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