J Korean Assoc Oral Maxillofac Surg.  2006 Apr;32(2):168-173.

The infection control method for early radiation therapy in the head and neck cancer patients with advanced odontogenic infectious lesions : report of cases

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University(Wonju Christian Hospital), Korea. shkjwon-ju@hanmail.net
  • 2Department of Radiation oncology. Wonju College of Medicine, Yonsei University, Korea.
  • 3Department of Dental Hygiene, Wonju College of Medicine, Yonsei University, Korea.
  • 4Department of Dentistry, Dong San Medical Center, College of Medicine, Keimyung University, Korea.

Abstract

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 and 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 and drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

Keyword

Early radiation therapy; Head and neck cancer; Odontogenic infectious lesions; Conservative endodontic drainage
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