Objectives: Dosimetric distribution of intensity-modulated radiotherapy (IMRT) to tooth-bearing areas for common head and neck (H&N) cancer sites were analyzed to facilitate minimization of osteoradionecrosis (ORN) risk through preradiation dental treatment planning.
Study Design: Fifty-four patients received IMRT with prescribed doses ranging from 6000 centigrays (cGy) (adjuvant) to 6930 cGy (primary) to treat base of tongue (BOT), tonsil, larynx, nasopharynx, and hypopharynx cancers. The average maximal radiation dose delivered was recorded in tooth-bearing areas (anteriors, premolars, and first, second, and third molars) of the maxilla and mandible.
Results: All tooth-bearing areas in laryngeal cancer cases received less than 2500 cGy. Maxillary and mandibular molar regions for BOT, tonsil, and hypopharynx cancers received 5000 cGy or higher. In nasopharynx cancers, maxillary teeth received higher doses than mandibular teeth.
Conclusions: Among 5 H&N subsites, mandibular molar regions for BOT, tonsil, and hypopharynx cancers received higher IMRT doses on average, posing the greatest ORN risk.
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http://dx.doi.org/10.1016/j.oooo.2015.10.007 | DOI Listing |
J Clin Med
November 2024
Department of Pediatric Dentistry and Preclinical Dentistry, Medical University in Wrocław, Krakowska 26, 50-425 Wrocław, Poland.
Cemento-osseous dysplasias (CODs) are rare lesions of the jawbone. Their occurrence, localization, type, size, and shape can vary between cases. This fibro-osseous lesion is typically found in the jaw near tooth-bearing areas and is often asymptomatic, discovered incidentally, and may be associated with the periapical region of the teeth.
View Article and Find Full Text PDFAm J Surg Pathol
October 2024
Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, Netherlands.
J Oral Implantol
August 2024
Department of Oral and Maxillofacial Surgery, The University of California San Francisco, San Francisco, California.
We present a case of an infection on a zygomaticus implant presenting on the skin, mimicking a cutaneous carcinoma, and presenting to a head and neck tumor board. The clinical findings were an intermittently discharging lesion over the zygomatic bone, which resolved upon removing the offending zygomaticus implant. It is essential to be aware that infections on a zygomaticus implant can occur well away from the normal tooth-bearing areas, and having a dentist with knowledge of these implants on a tumor board can prevent misdiagnosis and treatment.
View Article and Find Full Text PDFCureus
January 2024
Orthodontics and Dentofacial Orthopaedics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) University, Chennai, IND.
Introduction Facial asymmetry influences aesthetics and can involve either hard or soft tissues or both. Underlying skeletal asymmetry can be compensated by differential expression of soft tissue thickness on either side. Orthognathic surgical planning needs to take the interaction between the hard and soft tissues into account.
View Article and Find Full Text PDFDent Clin North Am
October 2023
Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA. Electronic address:
Patients with a history of head and neck radiation involving or adjacent to tooth-bearing areas are at increased risk of developing osteonecrosis following dental procedures. The dental provider should thus aim to preserve the patient's dentition after radiation therapy. Root canal therapy with coronectomy may be an option for a nonrestorable tooth, whereas atraumatic extraction can be considered if retaining the tooth is impossible.
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