Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제32권2호
  • /
  • Pages.168-173
  • /
  • 2006
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

진행성 치성감염 병소들을 가진 두경부 악성종양 환자에서 조기 방사선치료를 위한 치성감염 조절법 : 증례보고

THE INFECTION CONTROL METHOD FOR EARLY RADIATION THERAPY IN THE HEAD & NECK CANCER PATIENTS WITH ADVANCED ODONTOGENIC INFECTIOUS LESIONS : REPORT OF CASES

  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 이종영 (연세대학교 원주의과대학 방사선 종양학과) ;
  • 정원균 (연세대학교 원주의과대학 치위생학과) ;
  • 김영남 (연세대학교 원주의과대학 치위생학과) ;
  • 장선옥 (연세대학교 원주의과대학 치위생학과) ;
  • 전현선 (연세대학교 원주의과대학 치위생학과) ;
  • 김종배 (계명대학교 의과대학 동산의료원 치과학교실) ;
  • 남기영 (계명대학교 의과대학 동산의료원 치과학교실)
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital)) ;
  • Lee, Jong-Young (Department of Radiation oncology. Wonju College of Medicine, Yonsei University) ;
  • Chung, Won-Gyun (Department of Dental Hygiene, Wonju College of Medicine, Yonsei University) ;
  • Kim, Young-Nam (Department of Dental Hygiene, Wonju College of Medicine, Yonsei University) ;
  • Jang, Sun-Ok (Department of Dental Hygiene, Wonju College of Medicine, Yonsei University) ;
  • Jeon, Hyun-Sun (Department of Dental Hygiene, Wonju College of Medicine, Yonsei University) ;
  • Kim, Jong-Bae (Department of Dentistry, Dong San Medical Center, College of Medicine, Keimyung University) ;
  • Nam, Ki-Young (Department of Dentistry, Dong San Medical Center, College of Medicine, Keimyung University)
  • 발행 : 2006.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

키워드

참고문헌

  1. Conley JJ: Complications of head and neck surgery. Philadelphia, WB Saunders. 1979, pp335-339
  2. Little JW, Falace DA: Dental management of the medically compromised patient. St. Louis, CV Mosby. 1993, pp460-482
  3. Kaban LB, Pogrel MA, Perrott DH: Complications in oral and maxillofacial surgery. Philadelphia, WB Saunders. 1997, pp121-163
  4. 김명진, 김여갑, 김용각, 류동목, 이종호, 차인호 외 12인: 구강암. 서울, 지성출판사. 2002, pp498-805
  5. Mossman KL, Henkin RI: Radiation-induced changes in taste acuity in cancer patients. International Journal of Radiation Oncology, Biology, Physics. 1978;4:663-670
  6. Nikoskelainen J: Oral infections related to radiation and immunosuppressive therapy. J Clin Periodontol 1990;17:504-510 https://doi.org/10.1111/j.1365-2710.1992.tb01224.x
  7. Daly TE: Dentistry for the irradiated head and neck cancer patient. Cancer Bull 1979;29:74-80
  8. Jansma J, Vissink A, Spijkervet FK: Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy. Cancer 1992;70:2171-2177 https://doi.org/10.1002/1097-0142(19921015)70:8<2171::AID-CNCR2820700827>3.0.CO;2-S
  9. Murray CG, Herson J, Daly T: Radiation necrosis of the mandible : a ten year study. Int J Radiat Oncol Biol Phys 1980;6:543-548 https://doi.org/10.1016/0360-3016(80)90380-6
  10. Regezi JA, Courtney RM, Kerr DA: Dental management of patients irradiated for oral cancer. Cancer 1976;38:994-999 https://doi.org/10.1002/1097-0142(197608)38:2<994::AID-CNCR2820380251>3.0.CO;2-B
  11. Carl W, Schaaf NG, Sako K: Oral surgery and the patient who has radiation therapy for head and neck cancer. Oral Surg 1973;36:651- 656 https://doi.org/10.1016/0030-4220(73)90134-5
  12. Murray CG, Daly TE, Zimmerman SO: The relationship between dental disease and rediation necrosis of the mandible. Oral Surg 1980;49:99-104 https://doi.org/10.1016/0030-4220(80)90299-6
  13. Rutkauskas JS: Nonsurgical management of head and neck cancer patients. Dent Clin Nor Am 1994;38:425-445
  14. Wright WE, Haller JM, Harlow SA: An oral disease prevention program for patients receiving radiation and chemotherapy. J Am Dent Asso 1985;110:43-49 https://doi.org/10.14219/jada.archive.1985.0292
  15. 김영일: 방사선치료. 서울, 신광출판사. 1984, pp10-36
  16. 허 준: 방사선생물학. 서울, 고문사. 1987, pp51-158
  17. Marx RE: Studies in the radiobiology of osteoradionecrosis and their clinical significance. J Oral Surg 1987;45:379-390 https://doi.org/10.1016/0278-2391(87)90394-6
  18. Peterson LJ, Ellis IIIE, Hupp JR, Tucher MR: Contemporary oral and maxillofacial surgery. St. Louis, CV Mosby. 1988, pp425-436
  19. Topazian DS: Prevention of osteoradionecrosis of the jaw. Oral Surg Oral Med & Oral Patho 1959;17:530-538
  20. Markitziu A: Effect of single versus fractionated doses of x-radiation on developing molars in rats. J Dent Res 1974;53:637-640 https://doi.org/10.1177/00220345740530032001
  21. Meyer IM: Tissue healing and infection in experimental animals irradiated with Cobalt-60 and orthovoltage. Oral Surg Oral Med & Oral Patho 1966;22:333-340
  22. Sweeney WT: Histologic effect of fractionated doses of selectively applied Cobalt-60 irradiation on the teeth of Albino rats. J Dent Res 1977;56:1403-1407 https://doi.org/10.1177/00220345770560112101
  23. Colby RA: Radiation effects on structures of the oral cavity. J Am Dent Asso 1942;29:1446-1451 https://doi.org/10.14219/jada.archive.1942.0181
  24. 김용각: 구강암 환자의 치과치료. 대한치과의사협회지 1986; 24:587-595
  25. Liu RP, Fleming TJ, Toth BB: Salivary flow rates in patients with head & neck cancer 0.5 to 25years after radiotherapy. Oral Surg Oral Med Oral Pathol 1990;70:724-729 https://doi.org/10.1016/0030-4220(90)90008-G
  26. Epstein JB, Loh R, Stevenson-Moore P: Chlorhexidine rinse in prevention of dental caries in patients following radiation therapy. Oral Surg Oral Med Oral Pathol 1989;68:401-406 https://doi.org/10.1016/0030-4220(89)90136-9
  27. 이의웅: 방사선조사가 백서 악골 및 발치창치유에 미치는 영향에 관한 실험적 연구. 연세치대 논문집 1981;1:214-224
  28. Topazian RG, Goldberg MH: Management of infections of the oral and maxillofacial regions. Philadelphia, WB Saunders. 1981, pp258-265
  29. 임성삼: 임상 근관치료학. 서울, 도서출판 의치학사 1994, pp1-15
  30. Grossman LI: Endodontic practice, 8th ed. Philadelphia, WB Saunders. 1974, pp151-168