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Oncology

Is inadequate osseointegration a concern in radiation-treated patients, if implants are treatment planned?

This question was submitted by a general dentist: Is inadequate osseointegration a concern in patients who have received radiation therapy for a head and neck malignancy if implants are treatment planned? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question Yes, however … As with most questions related to this patient population, the answer is: “it depends.” Careful examination is a vital step in determining which restorative/prosthodontic approach best suits the individual. Examination also mandates a thorough review of their cancer diagnosis as well as the constituents and sequence ...

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What are the risk factors for osteoradionecrosis (ORN), in a xerostomic radiation-treated patient, if extractions are required?

This question was submitted to us by a general dentist: If extractions are required, what are the risk factors for osteoradionecrosis (ORN) in a xerostomic patient with rampant decay two years after the successful treatment of their head and neck cancer (radiation, chemotherapy and surgery)? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question:  With the numerous comorbidities associated with head and neck radiation (oral mucositis, radiodermatitis, dysgeusia, dysphagia/odynophagia, trismus, and xerostomia), arises a critical issue with tooth extraction is the altered biology of the maxilla and mandible due ...

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