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Clinical and translational radiation oncology · 2026

Prediction of high-dose regions in the jaw as a basis for decision-making in dental rehabilitation prior to radiotherapy in the head and neck area.

СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Staufenbiel Ingmar, Adam Knut, Flohr Marco, Wichmann Joern, Christiansen Hans, Schlueter Nadine, Clare Moog Liv Julia, Blach Robert, Vach Kirstin, Merten Roland

Аннотация

BACKGROUND AND PURPOSE: Radiotherapy to the head and neck can lead to severe side effects including xerostomia, caries, and in worst cases to osteoradionecrosis. Dental rehabilitation prior to radiotherapy is strongly recommended to reduce osteoradionecrosis risk, ideally in a dose-dependent manner. However, dentists do not know where high radiation doses are expected and radical tooth extractions continue to be performed. Study aim was to determine the radiation exposure in different dental regions depending on the tumour location to create a decision tree for clinicians.

METHODS: The present retrospective study included data of 112 irradiated patients, from which the mean radiation exposure in various dental regions (anterior, intermediary, posterior) of both jaws (upper, lower) was calculated depending on the radiotherapy concept (definitive, adjuvant) and the region of the tumour to be irradiated (oral cavity, oropharynx, hypopharynx, larynx) resulting in 48 subgroups of dental regions. Statistics: linear mixed models with patient as random factor for group differences; multiple testing: Scheffé correction, α = 5%.

RESULTS: Regarding the location, in particular irradiation of oral cavity and oropharyngeal tumours appears to lead to higher radiation exposures, same applies for definitive radiotherapy concepts and the molar region. Considering a radiation exposure of < 40 Gy as the threshold for low risk and > 50 Gy for high risk for severe side effects, of the 48 dental regions 8/10/30 were at high/medium/low risk.

CONCLUSION: In cases where medium/low risk is expected, radical extraction regimes should be reconsidered. Based on the results, a decision tree for dental rehabilitation planning was developed.