title: Prospectively-collected, tooth-specific dosimetry correlated with adverse dental outcomes.
abstract: OBJECTIVE
  To correlate radiation dose to specific tooth-bearing portions of bone with adverse dental outcomes.
  
  
  METHODS
  Eighty-nine patients treated with intensity-modulated radiation therapy with or without chemotherapy had radiation dose to specific tooth-bearing portions of the mandible and the maxilla. Data were collected prospectively during treatment planning, which resulted in 2490 data points. These patients underwent a comprehensive dental intake evaluation that included measurement of pocket depths and were then followed up with serial dental evaluations for a median of 2.5 years (range 0.2-6.9 years).
  
  
  RESULTS
  At the patient level, the 3-year risks of osteoradionecrosis (ORN) and periodontal disease were 2.5% and 36.6%, respectively. For any individual tooth, the risks of ORN and periodontal disease were 0.1% and 5.1%, respectively, at 3 years. Radiation dose to individual tooth-bearing portions of bone was correlated with ORN development (P = .0165). Periodontal disease also demonstrated a significant, but more gradual, dose response (P = .0395).
  
  
  CONCLUSIONS
  Adverse dental outcomes directly correlate with increased tooth-specific doses.
authors.affiliation: Penrose Cancer Center, Colorado Springs, Colorado, USA. Electronic address: dralmonroe@yahoo.com.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Monroe
authors.affiliation: Penrose Cancer Center, Colorado Springs, Colorado, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Flesher-Bratt
authors.affiliation: Independent Statistician, Colorado Springs, Colorado, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.affiliation: Penrose Cancer Center, Colorado Springs, Colorado, USA.
authors.forename: Anuj V
authors.initials: AV
authors.lastname: Peddada
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000453:epidemiology* / Q000628:therapy; D010510:Periodontal Diseases / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D011829:Radiation Dosage; D011874:Radiometry; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014070:Tooth / Q000528:radiation effects*