[Teeth and irradiation: dental care and treatment of osteoradionecrosis after irradiation in head and neck cancer].
Pre-irradiation dental care depends on teeth health, fields and dose of irradiation, compliance to fluorides, cessation of tobacco and psychosocial cofactors. Dental care aims at preventing complications and preserving the quality of life (eating, speech, and aesthetics). The role of hyperbaric oxygenotherapy for the prevention of osteoradionecrosis after teeth removal on the mandibula in areas receiving 50 Gy or more is still controversial. Medical treatments may be sufficient for early stages of osteoradionecrosis (antibiotics, pain killers, non-steroidal anti-inflammatory drugs as well as clodronate, vitamin E, pentoxifyllin). However, reconstructive surgery should not be delayed in advanced stages of osteoradionecrosis. New irradiation techniques are changing dose distributions and therefore require close collaboration between odonto-stomatologists and radiation oncologists to define the best dental care.
Thariat
J
J
Service de radiothérapie, centre Antoine-Lacassagne, 33 avenue de Valombrose, Nice, France. jthariat@hotmail.com
de Mones
E
E
Darcourt
V
V
Poissonnet
G
G
Marcy
P-Y
PY
Guevara
N
N
Bozec
A
A
Ortholan
C
C
Santini
J
J
Bensadoun
R-J
RJ
Dassonville
O
O
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003729:Dental Care / Q000592:standards*; D005459:Fluorides / Q000008:administration & dosage / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D010025:Osteoradionecrosis / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D010431:Pentoxifylline / Q000627:therapeutic use; D011788:Quality of Life; D011832:Radiation Injuries / Q000517:prevention & control; D011837:Radiation-Protective Agents / Q000627:therapeutic use; D019651:Plastic Surgery Procedures; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods; D014965:X-Rays
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D011837:Radiation-Protective Agents; D005459:Fluorides; D010431:Pentoxifylline