DOI QR코드

DOI QR Code

Head and neck radiotherapy-induced changes in dentomaxillofacial structures detected on panoramic radiographs: A systematic review

  • Received : 2021.01.18
  • Accepted : 2021.02.26
  • Published : 2021.09.30

Abstract

Purpose: This study aimed to summarize the impact of neck and head radiation treatment on maxillofacial structures detected on panoramic radiographs. Materials and Methods: In this systematic review, the authors searched PubMed Central, Embase, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar for original research studies up to February 2020 that included the following Medical Subject Headings keywords: words related to "radiotherapy" and synonyms combined with keywords related to "panoramic radiography" and "oral diagnosis" and synonyms. Only original studies in English that investigated the maxillofacial effects of radiotherapy via panoramic radiographs were included. The quality of the selected manuscripts was evaluated by assessing the risk of bias using Cochrane's ROBINS-I tool for non-randomized studies. Results: Thirty-three studies were eligible and included in this review. The main objectives pertained to the assessment of the effects of radiation on maxillofacial structures, including bone architecture alterations, periodontal space widening, teeth development abnormalities, osteoradionecrosis, and implant bone loss. The number of participants evaluated ranged from 8 to 176. Conclusion: The interaction between ionizing radiation and maxillofacial structures results in hazard to the tissues involved, particularly the bone tissue, periosteum, connective tissue of the mucosa, and endothelium. Hard tissue changes due to radiation therapy can be detected on panoramic radiographs.

Keywords

References

  1. Di Carlo S, De Angelis F, Ciolfi A, Quarato A, Piccoli L, Pompa G, et al. Timing for implant placement in patients treated with radiotherapy of head and neck. Clin Ter 2019; 170: e345-51.
  2. Harrison JS, Stratemann S, Redding SW. Dental implants for patients who have had radiation treatment for head and neck cancer. Spec Care Dentist 2003; 23: 223-9. https://doi.org/10.1111/j.1754-4505.2003.tb00316.x
  3. Arcuri MR, Fridrich KL, Funk GF, Tabor MW, LaVelle WE. Titanium osseointegrated implants combined with hyperbaric oxygen therapy in previously irradiated mandibles. J Prosthet Dent 1997; 77: 177-83. https://doi.org/10.1016/S0022-3913(97)70232-4
  4. Schuurhuis JM, Stokman MA, Roodenburg JL, Reintsema H, Langendijk JA, Vissink A, et al. Efficacy of routine pre-radiation dental screening and dental follow-up in head and neck oncology patients on intermediate and late radiation effects. A retrospective evaluation. Radiother Oncol 2011; 101: 403-9. https://doi.org/10.1016/j.radonc.2011.09.018
  5. Hommez GM, De Meerleer GO, De Neve WJ, De Moor RJ. Effect of radiation dose on the prevalence of apical periodontitis - a dosimetric analysis. Clin Oral Investig 2012; 16: 1543-7. https://doi.org/10.1007/s00784-011-0665-1
  6. Munhoz L, Aoki EM, Cortes AR, de Freitas CF, Arita ES. Osteoporotic alterations in a group of different ethnicity Brazilian postmenopausal women: an observational study. Gerodontology 2018; 35: 101-9. https://doi.org/10.1111/ger.12322
  7. Knobloch K, Yoon U, Vogt PM. Preferred reporting items for systematic reviews and meta-analyses(PRISMA) statement and publication bias. J Craniomaxillofac Surg 2011; 39: 91-2. https://doi.org/10.1016/j.jcms.2010.11.001
  8. Sterne JA, Hernan MA, Reeves BC, Savovic H, Berkman ND, Meera Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919.
  9. Palma LF, Tateno RY, Remondes CM, Marcucci M, Cortes AR. Impact of radiotherapy on mandibular bone: a retrospective study of digital panoramic radiographs. Imaging Sci Dent 2020; 50: 31-6. https://doi.org/10.5624/isd.2020.50.1.31
  10. Hoogeveen RC, Hol ML, Pieters BR, Balgobind BV, Berkhout EW, Schoot RA, et al. An overview of radiological manifestations of acquired dental developmental disturbances in paediatric head and neck cancer survivors. Dentomaxillofac Radiol 2020; 49: 20190275. https://doi.org/10.1259/dmfr.20190275
  11. Hachleitner J, Brandtner C, Gaggl A, Koop M, Fastner G, Moser G, et al. Analysis of an in-house technique for temporary mandibulotomy and its impact on postoperative radiotherapy. Int J Oral Maxillofac Surg 2019; 48: 468-74. https://doi.org/10.1016/j.ijom.2018.11.007
  12. Kilinc G, Bulut G, Ertugrul F, Oren H, Demirag B, Demiral A, et al. Long-term dental anomalies after pediatric cancer treatment in children. Turk J Haematol 2019; 36: 155-61. https://doi.org/10.4274/tjh.galenos.2018.2018.0248
  13. Li H, Tan MD, Alexander S, Grinsell D, Ramakrishnan A. Comparative osteoradionecrosis rates in bony reconstructions for head and neck malignancy. J Plast Reconstr Aesthet Surg 2019; 72: 1478-83. https://doi.org/10.1016/j.bjps.2019.04.017
  14. Mattos VD, Ferman S, Magalhaes DM, Antunes HS, Lourenco SQ. Dental and craniofacial alterations in long-term survivors of childhood head and neck rhabdomyosarcoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127: 272-81. https://doi.org/10.1016/j.oooo.2018.12.012
  15. Pellegrino G, Tarsitano A, Ferri A, Corinaldesi G, Bianchi A, Marchetti C. Long-term results of osseointegrated implant-based dental rehabilitation in oncology patients reconstructed with a fibula free flap. Clin Implant Dent Relat Res 2018; 20: 852-9. https://doi.org/10.1111/cid.12658
  16. Markman RL, Conceicao-Vasconcelos KG, Brandao TB, Prado-Ribeiro AC, Santos-Silva AR, Lopes MA. Calcified carotid artery atheromas on panoramic radiographs of head and neck cancer patients before and after radiotherapy. Med Oral Patol Oral Cir Bucal 2017; 22: e153-8.
  17. Owosho AA, Tsai CJ, Lee RS, Freymiller H, Kadempour A, Varthis S, et al. The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): The Memorial Sloan Kettering Cancer Center experience. Oral Oncol 2017; 64: 44-51. https://doi.org/10.1016/j.oraloncology.2016.11.015
  18. Tanaka M, Kamata T, Yanagisawa R, Morita D, Saito S, Sakashita K, et al. Increasing risk of disturbed root development in permanent teeth in childhood cancer survivors undergoing cancer treatment at older age. J Pediatr Hematol Oncol 2017; 39: e150-4. https://doi.org/10.1097/MPH.0000000000000788
  19. Bengtsson M, Korduner M, Campbell V, Fransson P, Becktor J. Mandibular access osteotomy for tumor ablation: could a more tissue-preserving technique affect healing outcome? J Oral Maxillofac Surg 2016; 74: 2085-92. https://doi.org/10.1016/j.joms.2016.03.036
  20. Chan KC, Perschbacher SE, Lam EW, Hope AJ, McNiven A, Atenafu EG, et al. Mandibular changes on panoramic imaging after head and neck radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121: 666-72. https://doi.org/10.1016/j.oooo.2016.01.023
  21. Ernst N, Sachse C, Raguse JD, Stromberger C, Nelson K, Nahles S. Changes in peri-implant bone level and effect of potential inf-luential factors on dental implants in irradiated and nonirradiated patients following multimodal therapy due to head and neck cancer: a retrospective study. J Oral Maxillofac Surg 2016; 74: 1965-73. https://doi.org/10.1016/j.joms.2016.06.005
  22. Owosho AA, Brady P, Wolden SL, Wexler LH, Antonescu CR, Huryn JM, et al. Long-term effect of chemotherapy-intensity-modulated radiation therapy (chemo-IMRT) on dentofacial development in head and neck rhabdomyosarcoma patients. Pediatr Hematol Oncol 2016; 33: 383-92. https://doi.org/10.1080/08880018.2016.1219797
  23. Proc P, Szczepanska J, Skiba A, Zubowska M, Fendler W, Mlynarski W. Dental anomalies as late adverse effect among young children treated for cancer. Cancer Res Treat 2016; 48: 658-67. https://doi.org/10.4143/crt.2015.193
  24. Pompa G, Saccucci M, Di Carlo G, Brauner E, Valentini V, Di Carlo S, et al. Survival of dental implants in patients with oral cancer treated by surgery and radiotherapy: a retrospective study. BMC Oral Health 2015; 15: 5. https://doi.org/10.1186/1472-6831-15-5
  25. Dediol E, Cvrljevic I, Dobranic M, Uglesic V. Comparative study between lag screw and miniplate fixation for straight mid-line mandibular osteotomy. Int J Oral Maxillofac Surg 2014; 43: 399-404. https://doi.org/10.1016/j.ijom.2013.09.003
  26. Karagozoglu KH, Winters HA, Forouzanfar T, Schulten EA. Periosteal ossification of the vascular pedicle after reconstruction of continuity defects of the mandible and the maxilla with fibular free flaps: a retrospective study. Br J Oral Maxillofac Surg 2013; 51: 965-7. https://doi.org/10.1016/j.bjoms.2013.03.011
  27. Shen Y, Guo XH, Sun J, Li J, Shi J, Huang W, et al. Double-barrel vascularised fibula graft in mandibular reconstruction: a 10-year experience with an algorithm. J Plast Reconstr Aesthet Surg 2013; 66: 364-71. https://doi.org/10.1016/j.bjps.2012.10.005
  28. Cubukcu CE, Sevinir B, Ercan I. Disturbed dental development of permanent teeth in children with solid tumors and lymphomas. Pediatr Blood Cancer 2012; 58: 80-4. https://doi.org/10.1002/pbc.22902
  29. Khojastepour L, Bronoosh P, Zeinalzade M. Mandibular bone changes induced by head and neck radiotherapy. Indian J Dent Res 2012; 23: 774-7. https://doi.org/10.4103/0970-9290.111258
  30. Gomez DR, Estilo CL, Wolden SL, Zelefsky MJ, Kraus DH, Wong RJ, et al. Correlation of osteoradionecrosis and dental events with dosimetric parameters in intensity-modulated radiation therapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys 2011; 81: e207-13. https://doi.org/10.1016/j.ijrobp.2011.02.003
  31. Ben-David MA, Diamante M, Radawski JD, Vineberg KA, Stroup C, Murdoch-Kinch CA, et al. Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. Int J Radiat Oncol Biol Phys 2007; 68: 396-402. https://doi.org/10.1016/j.ijrobp.2006.11.059
  32. Bonan PR, Lopes MA, Pires FR, Almeida OP. Dental management of low socioeconomic level patients before radiotherapy of the head and neck with special emphasis on the prevention of osteoradionecrosis. Braz Dent J 2006; 17: 336-42. https://doi.org/10.1590/S0103-64402006000400013
  33. Lopes NN, Petrilli AS, Caran EM, Franca CM, Chilvarquer I, Lederman H. Dental abnormalities in children submitted to anti-neoplastic therapy. J Dent Child (Chic) 2006; 73: 140-5.
  34. Eisen MD, Weinstein GS, Chalian A, Machtay M, Kent K, Coia LR, et al. Morbidity after midline mandibulotomy and radiation therapy. Am J Otolaryngol 2000; 21: 312-7. https://doi.org/10.1053/ajot.2000.9870
  35. Freymiller EG, Sung EC, Friedlander AH. Detection of radiation-induced cervical atheromas by panoramic radiography. Oral Oncol 2000; 36: 175-9. https://doi.org/10.1016/S1368-8375(99)00072-X
  36. Marunick MT, Bahu SJ, Aref A. Osteoradionecrosis of the maxillary-orbital complex after neutron beam radiotherapy. Otolaryngol Head Neck Surg 2000; 123: 224-8. https://doi.org/10.1067/mhn.2000.107403
  37. Carl W, Ikner C. Dental extractions after radiation therapy in the head and neck area and hard tissue replacement(HTR) therapy: a preliminary study. J Prosthet Dent 1998; 79: 317-22. https://doi.org/10.1016/S0022-3913(98)70244-6
  38. Friedlander AH, Eichstaedt RM, Friedlander IK, Lambert PM. Detection of radiation-induced, accelerated atherosclerosis in patients with osteoradionecrosis by panoramic radiography. J Oral Maxillofac Surg 1998; 56: 455-9. https://doi.org/10.1016/S0278-2391(98)90712-1
  39. Friedlander AH, August M. The role of panoramic radiography in determining an increased risk of cervical atheromas in patients treated with therapeutic irradiation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85: 339-44. https://doi.org/10.1016/S1079-2104(98)90020-8
  40. Murray CG, Daly TE, Zimmerman SO. The relationship between dental disease and radiation necrosis of the mandible. Oral Surg Oral Med Oral Pathol 1980; 49: 99-104. https://doi.org/10.1016/0030-4220(80)90299-6
  41. Gupta N, Pal M, Rawat S, Grewal MS, Garg H, Chauhan D, et al. Radiation-induced dental caries, prevention and treatment - a systematic review. Natl J Maxillofac Surg 2015; 6: 160-6. https://doi.org/10.4103/0975-5950.183870
  42. Beech N, Robinson S, Porceddu S, Batstone M. Dental management of patients irradiated for head and neck cancer. Aust Dent J 2014; 59: 20-8. https://doi.org/10.1111/adj.12134
  43. Lalla RV, Treister N, Sollecito T, Schmidt B, Patton LL, Mohammadi K, et al. Oral complications at 6 months after radiation therapy for head and neck cancer. Oral Dis 2017; 23: 1134-43. https://doi.org/10.1111/odi.12710
  44. Sonis AL, Tarbell N, Valachovic RW, Gelber R, Schwenn M, Sallan S. Dentofacial development in long-term survivors of acute lymphoblastic leukemia. A comparison of three treatment modalities. Cancer 1990; 66: 2645-52. https://doi.org/10.1002/1097-0142(19901215)66:12<2645::AID-CNCR2820661230>3.0.CO;2-S
  45. Marx RE. Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg 1983; 41: 283-8. https://doi.org/10.1016/0278-2391(83)90294-X
  46. Leitzen C, Wilhelm-Buchstab T, Mudder T, Heimann M, Koch D, Schmeel C, et al. Patient positioning in head and neck cancer: setup variations and safety margins in helical tomotherapy. Strahlenther Onkol 2018; 194: 386-91. https://doi.org/10.1007/s00066-018-1265-7
  47. Surucu M, Shah KK, Roeske JC, Choi M, Small W, Emami B. Adaptive radiotherapy for head and neck cancer. Technol Cancer Res Treat 2017; 16: 218-23. https://doi.org/10.1177/1533034616662165