Rajesh V Lalla1, Nathaniel S Treister2, Thomas P Sollecito3, Brian L Schmidt4, Lauren L Patton5, Erika S Helgeson6, Alexander Lin7, Cynthia Rybczyk8, Robert Dowsett9, Upendra Hegde10, Timothy S Boyd11, Thomas G Duplinsky12, Michael T Brennan13. 1. Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA. Electronic address: Lalla@uchc.edu. 2. Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, MA, USA. 3. Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA; Division of Oral Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA. 4. Department of Oral and Maxillofacial Surgery and Bluestone Center for Clinical Research, New York University College of Dentistry, New York, NY, USA. 5. Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA. 6. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA. 7. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA. 8. Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA. 9. Division of Radiation Oncology, University of Connecticut Health, Farmington, CT, USA. 10. Division of Medical Oncology, University of Connecticut Health, Farmington, CT, USA. 11. Department of Radiation Oncology, Hartford Hospital, Hartford, CT, USA. 12. Department of Dentistry, Yale New Haven Hospital, New Haven, CT, USA. 13. Department of Oral Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC, USA.
Abstract
OBJECTIVE: The aim of this study was to examine effects of radiation therapy (RT) for head and neck cancer (HNC) on periodontal disease and relationships to caries. STUDY DESIGN: A multicenter prospective observational cohort study (OraRad) was conducted in patients undergoing RT for HNC. Assessments were conducted by calibrated examiners at the pre-RT (baseline) visit (n = 533), the 12-month visit (n = 414), and the 24-month visit (n = 365). RESULTS: The average whole mouth mean (standard error (SE)) distance from the cementoenamel junction to the gingival margin (CEJ-GM) decreased significantly from 0.43 (0.04) mm at baseline to 0.24 (0.04) mm at 12 months and 0.11 (0.04) mm at 24 months (P ≤ .001). Whole mouth mean (SE) percentage of sites with CEJ-GM distance of <0 mm increased significantly from 23.3% (1.0%) at baseline to 28.5% (1.0%) at 12 months and 30.5% (1.1%) at 24 months (P ≤ .02). Higher mean radiation dose to the mandible was associated with a greater increase in the percentage of mandibular sites with CEJ-GM distance of <0 mm (P = .003). Both mean CEJ-GM distance and the percentage of sites with a CEJ-GM distance <0 mm were strongly associated with whole mouth mean proportion of decayed, missing, and filled surfaces, as well as proportion of decayed or filled facial/buccal surfaces specifically, (P < .001), with greater gingival recession associated with increased caries. CONCLUSIONS: RT for HNC leads to mandibular gingival recession in a dose-dependent manner. This gingival recession may contribute to increased risk for cervical caries seen in these patients.
OBJECTIVE: The aim of this study was to examine effects of radiation therapy (RT) for head and neck cancer (HNC) on periodontal disease and relationships to caries. STUDY DESIGN: A multicenter prospective observational cohort study (OraRad) was conducted in patients undergoing RT for HNC. Assessments were conducted by calibrated examiners at the pre-RT (baseline) visit (n = 533), the 12-month visit (n = 414), and the 24-month visit (n = 365). RESULTS: The average whole mouth mean (standard error (SE)) distance from the cementoenamel junction to the gingival margin (CEJ-GM) decreased significantly from 0.43 (0.04) mm at baseline to 0.24 (0.04) mm at 12 months and 0.11 (0.04) mm at 24 months (P ≤ .001). Whole mouth mean (SE) percentage of sites with CEJ-GM distance of <0 mm increased significantly from 23.3% (1.0%) at baseline to 28.5% (1.0%) at 12 months and 30.5% (1.1%) at 24 months (P ≤ .02). Higher mean radiation dose to the mandible was associated with a greater increase in the percentage of mandibular sites with CEJ-GM distance of <0 mm (P = .003). Both mean CEJ-GM distance and the percentage of sites with a CEJ-GM distance <0 mm were strongly associated with whole mouth mean proportion of decayed, missing, and filled surfaces, as well as proportion of decayed or filled facial/buccal surfaces specifically, (P < .001), with greater gingival recession associated with increased caries. CONCLUSIONS: RT for HNC leads to mandibular gingival recession in a dose-dependent manner. This gingival recession may contribute to increased risk for cervical caries seen in these patients.
Authors: Natália Rangel Palmier; César Augusto Migliorati; Ana Carolina Prado-Ribeiro; Maria Cecília Querido de Oliveira; Aljomar José Vechiato Filho; Mario Fernando de Goes; Thais Bianca Brandão; Marcio Ajudarte Lopes; Alan Roger Santos-Silva Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Date: 2020-05-19
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Authors: Rajesh V Lalla; Leslie Long-Simpson; James S Hodges; Nathaniel Treister; Thomas Sollecito; Brian Schmidt; Lauren L Patton; Michael T Brennan Journal: BMC Oral Health Date: 2017-02-27 Impact factor: 2.757