This summary is based on the article published in the Journal of Prosthodontics: Updated Clinical Considerations for Dental Implant Therapy in Irradiated Head and Neck Cancer Patients (August 2013) Context An increasing number of reports indicate successful use of dental implants (DI) during oral rehabilitation for head and neck cancer patients undergoing tumor surgery and radiation therapy. Implant-supported dentures are a viable option when patients cannot use conventional dentures due to adverse effects of radiation therapy, including oral dryness or fragile mucosa, in addition to compromised anatomy. However, negative effects of radiation, including osteoradionecrosis, are well documented in the literature, and early loss of implants in irradiated ...Read More »
This question was submitted to us by a general dentist: How should we manage a patient undergoing an allogeneic bone marrow transplant? Dr. Jeff Chadwick, at Princess Margaret Cancer Centre, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question The allogeneic bone marrow transplant (BMT) is a medical procedure that may be employed for the treatment of several hematologic malignancies including, but not limited to, aplastic anemia, myelodysplastic syndrome, acute and chronic leukemias and lymphomas. BMTs typically involve the insertion of a central venous catheter (CVC), high dose chemotherapy and, in some cases, total body irradiation, prior ...Read More »
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 ...Read More »
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 ...Read More »