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Wetzels JWGH, Meijer GJ, Koole R, Adang EM, Merkx MAW, Speksnijder CM. Costs and clinical outcomes of implant placement during ablative surgery and postponed implant placement in curative oral oncology: a five-year retrospective cohort study. Clin Oral Implants Res 2017; 28:1433-1442. [DOI: 10.1111/clr.13008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Jan-Willem G. H. Wetzels
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
| | - Gert J. Meijer
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Ron Koole
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
| | - Eddy M. Adang
- Section Biostatistics; Department for Health Evidence; Radboud University Medical Center; Nijmegen The Netherlands
| | - Matthias A. W. Merkx
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Caroline M. Speksnijder
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
- Julius Center Sciences; University Medical Center Utrecht; Utrecht The Netherlands
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Wetzels JW, Koole R, Meijer GJ, de Haan AFJ, Merkx MAW, Speksnijder CM. Functional benefits of implants placed during ablative surgery: A 5-year prospective study on the prosthodontic rehabilitation of 56 edentulous oral cancer patients. Head Neck 2016; 38 Suppl 1:E2103-11. [DOI: 10.1002/hed.24389] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jan Willem Wetzels
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Ron Koole
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
| | - Gert J. Meijer
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Anton F. J. de Haan
- Department for Health Evidence, Section Biostatistics; Radboud University Medical Center; Nijmegen The Netherlands
| | - Matthias A. W. Merkx
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
| | - Caroline M. Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care; University Medical Center Utrecht; Utrecht The Netherlands
- Department of Oral and Maxillofacial Surgery; Radboud University Medical Center; Nijmegen The Netherlands
- Julius Center Sciences; University Medical Center Utrecht; Utrecht The Netherlands
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Prealbumin is a more sensitive marker than albumin to assess the nutritional status in patients undergoing radiotherapy for head and neck cancer. Contemp Oncol (Pozn) 2013; 17:276-80. [PMID: 24596514 PMCID: PMC3934060 DOI: 10.5114/wo.2013.35281] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 11/22/2012] [Accepted: 11/27/2012] [Indexed: 01/23/2023] Open
Abstract
Aim of the study The aim of this prospective study was to determine the prevalence of malnutrition and to evaluate a more sensitive marker to assess the nutritional status in patients undergoing RT for head and neck cancer. Material and methods The prospective study included 51 (mean age of 57.6 ±11.2 years) patients undergoing RT for head and neck cancer. Malnutrition was defined as weight loss > 5% of baseline. Results Forty-six (90.2%) of 51 patients were male. Malnutrition developed in 33 (64.7%) patients during RT. Mean prealbumin level was significantly lower in patients with malnutrition than in those without malnutrition (17 ±5 g/dl vs. 22 ±5 g/dl, respectively, p = 0.004). On the other hand, there was no significant difference between the two groups in terms of other nutrition parameters including total protein, albumin, total cholesterol, triglyceride, and glucose (p > 0.05). The percentage of weight loss negatively correlated with prealbumin (r = –0.430, p = 0.002), but not with other nutrition parameters including total protein, albumin, triglyceride, total cholesterol, HDL cholesterol, LDL cholesterol, and glucose (p > 0.05). Conclusions The prevalence of malnutrition was high in patients with head and neck cancer. Prealbumin was a more sensitive marker than albumin to assess the nutritional status in these patients.
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Katsura K, Sasai K, Sato K, Saito M, Hoshina H, Hayashi T. Relationship between oral health status and development of osteoradionecrosis of the mandible: A retrospective longitudinal study. ACTA ACUST UNITED AC 2008; 105:731-8. [DOI: 10.1016/j.tripleo.2007.10.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 09/27/2007] [Accepted: 10/05/2007] [Indexed: 12/01/2022]
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Lazarus C, Logemann JA, Pauloski BR, Rademaker AW, Helenowski IB, Vonesh EF, Maccracken E, Mittal BB, Vokes EE, Haraf DJ. Effects of radiotherapy with or without chemotherapy on tongue strength and swallowing in patients with oral cancer. Head Neck 2007; 29:632-7. [PMID: 17230558 DOI: 10.1002/hed.20577] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Oral tongue strength and swallowing ability are reduced in patients treated with chemoradiotherapy for oral and oropharyngeal cancer. METHODS Patients with oral or oropharyngeal cancer treated with high-dose chemoradiotherapy underwent tongue strength, swallowing, and dietary assessments at pretreatment and 1, 3, 6, and 12 months posttreatment. Tongue strength was assessed using the Iowa Oral Performance Instrument (IOPI). Oral and pharyngeal residue was evaluated utilizing videofluoroscopy. RESULTS Mean maximum tongue strength dropped a nonsignificant amount immediately after treatment, and then increased significantly at 6- and 12-months posttreatment completion. Analyses were adjusted for patient dropout. Tongue strength was not significantly correlated with swallow observations of percentage oral and pharyngeal residue. Ability to eat various diet consistencies was reduced after treatment but improved over time at a rate similar to changes in oral intake and type of diet. CONCLUSIONS Parallel but not significant changes in oral intake, diet, and tongue strength in the first year post chemoradiation therapy need further study in a larger population.
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Affiliation(s)
- Cathy Lazarus
- Voice, Speech and Language Service and Swallowing Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Mohammadi N, Seyyednejhad F, Alizadeh Oskoee P, Savadi Oskoee S, Mofidi N. Evaluation of Radiation-induced Xerostomia in Patients with Nasopharyngeal Carcinomas. J Dent Res Dent Clin Dent Prospects 2007; 1:65-70. [PMID: 23277836 PMCID: PMC3525927 DOI: 10.5681/joddd.2007.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 09/01/2007] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIMS Salivary glands are extremely susceptible to radiation injuries. The aim of this study was to evaluate radiation-induced xerostomia in patients with nasopharyngeal carcinomas, referring to Tabriz Imam Khomeini Hospital in 2005-2006. MATERIALS AND METHODS Thirty patients with nasopharyngeal carcinomas, who received conventional radiotherapy, were included in the present study. The patients' unstimulated saliva samples were collected at three intervals, i.e. before treatment, 3 weeks after the initiation of treatment and at the end of treatment by spitting, and measured with a graduated pipette. RESULTS The differences in the mean values of the patients' salivary flow rates at three afore-mentioned intervals were statistically significant (p<0.001). Two-by-two comparison of the mean values of salivary flow rates of all the patients and of males and females, carried out separately, demonstrated statistically significant differences (p<0.0025). However, there were no statistically significant differences between males and females before treatment (p = 0.723), 3 weeks after the initiation of treatment (p = 0.724) and at the end of treatment (p = 0.595). There were no statistically significant relationships between age and a decrease in salivary flow rate in the total sample (p = 0.76, r = -0.057), in males (p = 0.96, r = 0.011) and in females (p = 0.539, r = -0.208). CONCLUSION Conventional radiotherapy results in severe xerostomia in 3 weeks in patients with nasopharyngeal carcinomas. Age and sex do not influence radiotherapy-induced xerostomia.
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Affiliation(s)
- Narmin Mohammadi
- Assistant Professor, Department of Operative Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Iran
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Penner JL, McClement SE, Sawatzky JAV. Management of dysphagia in advanced oropharyngeal cancer. Int J Palliat Nurs 2007; 13:206-12. [PMID: 17577172 DOI: 10.12968/ijpn.2007.13.5.23498] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Individuals with advanced oropharyngeal cancer often experience dysphagia as a result of their illness and its treatment. Research consistently demonstrates that dysphagia and difficulty with oral intake have many implications, including a negative impact on quality of life. Nurses are in a key position to provide support and initiate appropriate interventions for individuals with dysphagia. Using the Human Response to Illness model (Mitchell et al, 1991) as an organising framework, this paper presents a critical review of the empirical literature regarding dysphagia in individuals with advanced oropharyngeal cancer that will: i) provide the reader with a comprehensive understanding of dysphagia; ii) identify current gaps in our knowledge; and iii) establish the foundation for appropriate evidence-based interventions to optimise functioning and quality of life in this patient population.
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Abstract
BACKGROUND Dysphagia is a common symptom of head and neck cancer or sequelae of its management. Swallowing disorders related to head and neck cancer are often predictable, depending on the structures or treatment modality involved. Dysphagia can profoundly affect posttreatment recovery as it may contribute to aspiration pneumonia, dehydration, malnutrition, poor wound healing, and reduced tolerance to medical treatments. METHODS The author reviewed the normal anatomy and physiology of swallowing and contrasted it with the commonly identified swallowing deficits related to head and neck cancer management. Evaluation methods and treatment strategies that can be used to successfully manage the physical and psychosocial effects of dysphagia are also reviewed. RESULTS Evaluation of dysphagia by the speech pathologist can be achieved with instrumental and noninstrumental methods. Once accurate identification of the deficits is completed, a range of treatment strategies can be applied that may return patients to safe oral intake, improve nutritional status, and enhance quality of life. CONCLUSIONS To improve safety of oral intake, normalize nutritional status, reduce complications of cancer treatment and enhance quality of life, accurate identification of swallowing disorders and efficient management of dysphagia symptoms must be achieved in an interdisciplinary team environment.
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Affiliation(s)
- Joy E Gaziano
- Speech Pathology Department, H. Lee Moffitt Cancer Center Research Institute, Tampa, Florida 33612, USA.
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Abstract
Periodontal infection may exacerbate during cancer therapy and may result in oral pain and infection, and systemic infection, which may cause morbidity and can lead to mortality in neutropenic cancer patients. Periodontal disease in head and neck cancer patients treated with radiation therapy may lead to acute and chronic complications. The literature was reviewed by a search of Medline of the National Library of Medicine. The search was conducted to identify publications assessing periodontal disease in cancer patients. In addition, a review of papers referenced in the retrieved papers was conducted to identify additional publications for review. Periodontal disease should be assessed and managed prior to medical treatment of cancer for those with oropharyngeal cancer, and for patients in whom neutropenia may develop during treatment. Pretreatment assessment and management, and maintenance of oral hygiene have been shown to be effective in preventing oral and systemic complications during treatment. A complete oral and periodontal examination is appropriate for all patients planned to receive head and neck radiation therapy and those to be treated with medical protocols that are anticipated to result in neutropenia. Oral and periodontal care must continue following cancer therapy, and requires that the health care provider have an understanding of the malignant disease, oral manifestations of the disease, medical management of the disease, and of the oral complications that may develop.
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Affiliation(s)
- J B Epstein
- British Columbia Cancer Agency, Vancouver Hospital and Health Sciences Centre, 600 West 10th Avenue, Vancouver, BC, Canada V5Z 4E6.
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Lazarus CL, Logemann JA, Pauloski BR, Rademaker AW, Larson CR, Mittal BB, Pierce M. Swallowing and tongue function following treatment for oral and oropharyngeal cancer. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2000; 43:1011-1023. [PMID: 11386468 DOI: 10.1044/jslhr.4304.1011] [Citation(s) in RCA: 142] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study examined tongue function and its relation to swallowing in 13 subjects with oral or oropharyngeal cancer treated with primary radiotherapy +/- chemotherapy and 13 age- and sex-matched control subjects. Measures of swallowing and tongue function were obtained using videofluoroscopy, pretreatment and 2 months posttreatment. Maximum isometric strength and endurance at 50% of maximum strength were obtained with the Iowa Oral Performance Instrument (IOPI). Control subjects were tested once. All subjects with head and neck cancer were evaluated pretreatment and 2 months posttreatment. No significant differences were found for the tongue function measures pre- and 2 months posttreatment in the group with head and neck cancer. Significantly higher tongue strength was observed in the control than in the group with head and neck cancer both pre- and posttreatment. No significant differences were found for the 2 groups for tongue endurance measures. Significant correlations of tongue strength and endurance and some swallow measures were found pre- and posttreatment for the group with head and neck cancer and for the control group. These correlations included oral and pharyngeal temporal swallow measures and oropharyngeal swallow efficiency. Pretreatment differences between the 2 groups in tongue strength were likely related to tumor bulk, pain, and soreness. Two-month posttreatment differences were likely related to radiation +/- chemotherapy changes to the oral and pharyngeal mucosa. This study provides support for the hypothesis that tongue strength plays a role in oropharyngeal swallowing, particularly related to the oral phase of the swallow.
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Affiliation(s)
- C L Lazarus
- Voice, Speech and Language Service and Swallowing Center, Northwestern University Medical School, Chicago, IL 60611, USA.
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Epstein JB, Lunn R, Le N, Stevenson-Moore P. Periodontal attachment loss in patients after head and neck radiation therapy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 86:673-7. [PMID: 9868723 DOI: 10.1016/s1079-2104(98)90202-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the potential impact of head and neck radiation therapy on the progression of periodontal attachment loss. STUDY DESIGN Ten patients who received unilateral radiation fields that included the dentition were assessed before radiation treatment and after irradiation at a mean age of 6.01 years. Complete oral, dental, and periodontal examinations were completed by one examiner. The results were assessed through use of paired t tests. RESULTS More teeth were extracted because of periodontal disease in the field of radiation after irradiation. Remaining teeth in the radiated volume showed an increase in probing depth of 0.82 mm in comparison with 0.40 mm for teeth in the nonradiated region (P = .05). Recession on the facial aspects was 1.88 mm for teeth in the radiated volume and 1.16 mm for teeth in the nonradiated region (P = .001), and recession on the lingual aspects was 2.10 for teeth in the radiated volume and 0.91 for teeth in the nonradiated region (P = .05). Mean total attachment loss was 2.81 mm for teeth in the radiated sites; this compared with 1.43 mm for teeth in the nonradiated sites (P = .003). Increased mobility of teeth in the high-dose fields was seen (P = .02). CONCLUSIONS This study showed that tooth loss and greater periodontal attachment loss occur in teeth that are included within high-dose radiated sites of patients treated with irradiation therapy for cancer. These findings should be considered in preradiation treatment planning.
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Affiliation(s)
- J B Epstein
- British Columbia Cancer Agency, Vancouver, Canada
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Abstract
STATEMENT OF PROBLEM Low fusing alloy has been used in dentistry for remount procedures in both fixed and removable prosthodontics, in implant prosthodontics for the fabrication of solid implant casts, in maxillofacial prosthetics as oral radiation shields, and in dental research for its unique properties. Previously, the use of low fusing alloy was thought to offer a high degree of dimensional accuracy. However, multiple in vitro studies have shown that its presumed dimensional accuracy may be questionable. PURPOSE This article reviews the physical properties, metallurgical considerations of low fusing alloy, its applications in dentistry, and a safe, simple method of using low fusing alloy.
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Affiliation(s)
- A G Wee
- College of Dentistry, University of Iowa, Iowa City, USA
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