Extractions dentaires en territoire irradié

Chaux-Bodard, Anne-Gaëlle; Gourmet, R.; Montbarbon, X.; Bodard, Stéphane; Breton, P.

doi:10.1016/s0035-1768(04)72325-6

Cited by 17 publications

(3 citation statements)

References 11 publications

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“…Although it typically appears from 3 to 27 months after radiotherapy, the risk of osteoradionecrosis is thought to extend indefinitely after irradiation [20, 21]. Our findings on time to development (7.7 months, range 3.4–27.1 months) are similar to those of previous reports [4].…”

Section: Discussionsupporting

confidence: 89%

Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Zhang

Yang

et al. 2017

Radiotherapy and Oncology

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Purpose We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). Methods and materials We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher’s exact test. Results Median follow-up time for all patients (534 IMRT and IMPT) was 33.8 months (33.8 months IMRT vs. 34.6 months IMPT, P=0.854), and median time to osteoradionecrosis was 11.4 months (range 6.74–16.1 months). Mandibular doses were lower for patients treated with IMPT (minimum 0.8 vs. 7.3 Gy; mean 25.6 vs. 41.2 Gy; P<0.001), and osteoradionecrosis rates were lower as well: 2% IMPT (1 grade 1), 7.7% IMRT (12 grade 4, 5 grade 3, and 1 grade 2 and 23 grade 1). Osteoradionecrosis location depended on the primary tumor site and high-dose field in the mandible. Conclusions: Osteoradionecrosis events were significantly associated with higher dose irradiation to mandibular Use of IMPT minimized excess irradiation of the mandible and consequently reduced the risk of osteoradionecrosis for oropharyngeal cancer.

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Section: Discussionsupporting

confidence: 89%

Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Zhang

Yang

et al. 2017

Radiotherapy and Oncology

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“…There is damage to microvesiculation, resulted in initial hyperemia followed by endarteritis, thrombosis, and obliteration. [ 8 ]…”

Section: Discussionmentioning

confidence: 99%

Prophylactic use of pentoxifylline and tocopherol in patients undergoing dental extractions following radiotherapy for head and neck cancer

Aggarwal

Goutam²,

Singh³

et al. 2017

Niger J Surg

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Background:In head and neck cancer patients undergoing radiotherapy, osteoradionecrosis (ORN) of the jaw is one of the major but uncommon complications. Satisfactorily results have been observed while treating ORN patients with upcoming treatment modalities such as combination therapy of pentoxifylline and Vitamin E (PVe). It is believed that in patients undergoing dental extractions, these treatment modalities can be used prophylactically for lowering the risk of development of ORN. Hence, keeping all these things in mind, we planned the present study to assess the prophylactic role of pentoxifylline and tocopherol in patients who require dental extractions after radiotherapy for cancer of head and neck.Materials and Methods:A total of 110 patients were included in this retrospective study, which had radiotherapy for cancer of the head and neck. After radiotherapy, a total of 450 dental extractions were done in these 110 patients.Results:External beam therapy was given in 92.72% of the patients. 7.27% and 40% of the patients received intensity modulated radiotherapy combination of chemotherapy and intensity modulated radiotherapy, respectively. ORN developed only in 2 patients. Patients had taken PVe for a mean of 12 (24) weeks preoperatively and 14 (18) weeks postoperatively. The incidence was lower than that normally associated with dental extractions in irradiated patients.Conclusion:In patients undergoing dental extractions, after receiving radiotherapy of head and neck region, combination therapy of pentoxifylline and tocopherol are sufficiently effective.

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“…Initially the damage is seen in the smallest of vessels causing hyperaemia followed by endarteritis, thrombosis and, finally, total obliteration. 18 This hampers the tissue's ability to repair itself, and even routine physiological remodelling and repair decrease or cease. If this compromised tissue is then faced with increased repair requirements as a result of trauma, cellular death and collagen lysis will exceed synthesis and cellular replication, resulting in a non-healing wound in which the energy, oxygen and metabolic demands exceed the supply.…”

Section: Historical and Histopathological Perspectives In Osteoradion...mentioning

confidence: 99%

An update on the effects of radiation therapy and dental management of head and neck cancer patients

Mmutlana,

Sykes,

Naidu

2023

S. Afr. dent. j.

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Defects in the maxillofacial region may result in cosmetic, functional and psychological impairment which can have far reaching effects on patients’ quality of life. Head and neck cancer may be treated with a variety of modalities including surgical resection, chemotherapy and radiation therapy. Ionising radiation destroys tumour cells, rendering them less able to divide, and thereby halting tumour progression, but also destroys many normal cells leaving patients with a number of oral and/or facial side effects, some of which develop quickly and others only becoming evident after some time. This paper will review these complications and the effects they have on patient functionally, aesthetically and psychosocially. It will also propose ways in which dentists can be part of the multidisciplinary team who try to prevent, reduce or manage post radiation sequalae, and help restore patients’ dignity, functioning and general quality of life. The topic of osseointegrated implants in irradiated bone is a much debated, complex and controversial issue. This will be addressed in a follow-up review.

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Extractions dentaires en territoire irradié

Cited by 17 publications

References 11 publications

Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Intensity-modulated proton therapy and osteoradionecrosis in oropharyngeal cancer

Prophylactic use of pentoxifylline and tocopherol in patients undergoing dental extractions following radiotherapy for head and neck cancer

An update on the effects of radiation therapy and dental management of head and neck cancer patients

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