Oral sequelae of head and neck radiotherapy.
In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.
Vissink
A
A
Department of Oral and Maxillofacial Surgery, University Hospital, PO Box 30.001, 9700 RB Groningen, The Netherlands. A.Vissink@kchir.azg.nl
Jansma
J
J
Spijkervet
F K L
FK
Burlage
F R
FR
Coppes
R P
RP
D016371:Cranial Irradiation / Q000009:adverse effects*; D003731:Dental Caries / Q000209:etiology; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D007571:Jaw Diseases / Q000209:etiology; D009059:Mouth Diseases / Q000209:etiology*; D009061:Mouth Mucosa / Q000528:radiation effects*; D010025:Osteoradionecrosis / Q000209:etiology; D010519:Periodontium / Q000528:radiation effects; D011788:Quality of Life; D012469:Salivary Glands / Q000528:radiation effects; D013649:Taste / Q000528:radiation effects; D014987:Xerostomia / Q000150:complications / Q000209:etiology