Goon PKC, Stanley MA, Ebmeyer J, Steinstrasser L, Upile T, Jerjes W HPV and head and neck cancer: a descriptive update. Head Neck Oncol. 2009; 1
London: Cancer Research UK;
Haddad RI, Shin DM. Recent advances in head and neck cancer. New Eng J Med. 2008; 359:1143-1154
Pace-Balzan A, Shaw RJ, Butterworth CJ. Invited Review: Oral rehabilitation following treatment for oral cancer. Perio 2000. 2011; 57:102-117
Bruins H, Koole R, Jolly D. Pretherapy dental decisions in patients with head and neck cancer. Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 86:256-267
Hanock PJ, Epstein JB, Sadler GR. Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc. 2003; 69:585-590
Springer IN, Niehoff P, Warnke PH Radiation caries – radiogenic destruction of dental collagen. Oral Oncol. 2005; 41:723-728
Kielbassac AM, Hinkelnbein W, Hellwig E, Meyer-Luckel H. Radiation-related damage to dentition. Lancet Oncol. 2006; 7:326-335
Rogers SN, Fisher SE, Woolgar JA. A review of quality of life assessment in oral cancer. Int J Oral Maxillofac Surg. 1999; 28::99-117
Rogers SN, Gwanne S, Lowe D, Stat C, Humphris G, Yueh B The addition of mood and anxiety domains to the university of Washington quality of life scale. Head Neck. 2002; 24:521-529
Guidelines for the oral management of oncology patients requiring radiotherapy, chemotherapy and bone marrow transplant. J Disabil Oral Health. 2001; 2:3-14
Clayman L. Clinical controversies in oral and maxillofacial surgery: Part two. Management of dental extractions in irradiated jaws: a protocol without hyperbaric oxygen. J Oral Maxillofac Surg. 1997; 55:275-281
Shaw RJ, Sutton AF, Cawood JI, Howell RA, Lowe D, Brown JS Oral rehabilitation surgery following treatment for head and neck malignancy. Head Neck. 2005; 27:459-470
Schoen PJ, Reintsema H, Raghoebar GM, Vissink A, Roodenburg JL. The use of implant retained mandibular prostheses in the oral rehabilitation of head and neck cancer patients. A review and rationale for treatment planning. Oral Oncol. 2004; 40:862-871
Shaw RJ, Lowe D, Woolgar JA Extracapsular spread in oral squamous cell carcinoma. Head Neck. 2010; 32:714-722
Ganstrom G. Osseointegration in irradiated cancer patients: an analysis with respect to implant failures. J Oral Maxillofac Surg. 2005; 63:579-585
Kluth EV, Jain PR, Stechell RN, Frich JC. A study of factors contributing to the development of osteoradionecrosis of the jaws. J Prosthet Dent. 1988; 59:194-201
Ganstrom G, Tjellstrom A, Brånemark P. Osseointegrated implants in irradiated bone: a case controlled study using hyperbaric oxygen therapy. J Oral Maxillofac Surg. 1999; 7:493-499
Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK and Edge Hill University, Liverpool and Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk
Oral cancer patients undergo life-altering curative treatment that consists of surgery or a combination of surgery and radiotherapy. This can severely alter the functional anatomy of the oral cavity and create a challenging environment for successful oral rehabilitation. A multidisciplinary team approach is required to rehabilitate these patients successfully. It is essential to have assessment by an oral rehabilitation specialist before treatment, especially where primary rehabilitation interventions are being considered.
Following cancer treatment, patients may suffer from a range of difficulties, from dento-facial appearance, to chewing, speech and swallowing. This dysfunction often leads to psychosocial problems, such as reduced self esteem, social contact and quality of life. Conventional prosthodontics has a role to play in the management of these patients but osseointegrated implants (OII), can be required to overcome the anatomical and physiological barriers. OII can be used in an environment where there is poor soft tissue function or little bone support, and where there is a dry mouth.
Clinical Relevance: This paper introduces readers to the prosthodontic pathway taken by some oral cancer patients. It provides an overview of current oral rehabilitation techniques that supplement the supportive dental care provided by general dental practitioners and their team after cancer treatment.
Article
Head and neck cancer is the fifth most common cancer by incidence and the sixth most common cause of death from cancer worldwide.1 Oral cancer is the most prevalent type of head and neck cancer. In the UK in 2006, there were 5,325 people diagnosed with oral cancer and the incidence is increasing; Cancer Research UK has reported a 44% increase since 1995.2 More than 90% of head and neck cancers are squamous cell carcinomas and the progression of the disease results from alterations in the cellular and molecular pathways in the squamous epithelium.3
Head and neck cancer treatment comprises surgery, radiotherapy, chemotherapy, or a combination of these modalities. However, for oral cancer, primary surgery is the treatment of choice and this is followed by radiotherapy in patients with advanced disease. The focus of this paper is to summarize the role of prosthodontics in oral rehabilitation. The aim of surgical treatment is resection of the tumour with clear margins whilst maintaining as much post-operative function as possible. In addition to tumour ablation, a neck dissection can be indicated to remove lymph glands in the path of tumour drainage. Also, in large defects, reconstructive surgery is carried out using microvascular free tissue transfer.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
