Thariat J, De Mones E, Darcourt V, Poissonnet G, Dassonville O, Savoldelli C, Marcy P-Y, Odin G, Guevara N, Bozec A, Ortholan C, Santini J, Bensadoun R-J
Service de radiothérapie, centre Antoine-Lacassagne, 33 avenue de Valombrose, Nice, France.
Cancer Radiother. 2010 Apr;14(2):128-36. doi: 10.1016/j.canrad.2009.09.009. Epub 2010 Feb 26.
Pre-irradiation dental care depends on teeth health, fields and dose of irradiation, compliance to fluorides, cessation of tobacco and psychosocial cofactors. Dental care aims at preventing complications and preserving the quality of life (eating, speech and aesthetics). Approximately 11% of patients do not require any pre-irradiation dental care. Dental complications vary from slight colorations of the teeth to major complication such as osteoradionecrosis. Osteoradionecrosis rates vary from 1 to 9%, and may be decreased by using a 21-day delay between extractions and irradiation, provided that it does not postpone cancer treatment, with a dose-dependent risk (<6% if <40 Gy; 14% between 40 et 60 Gy; > or =20% if >60 Gy). Osteoradionecrosis occurs spontaneously (35%), mostly involves the mandibula (85%).
放疗前的牙齿护理取决于牙齿健康状况、放疗部位和剂量、氟化物的使用情况、戒烟情况以及心理社会因素。牙齿护理旨在预防并发症并维持生活质量（饮食、言语和美观）。约11%的患者不需要任何放疗前牙齿护理。牙齿并发症从牙齿轻微变色到严重并发症如放射性骨坏死不等。放射性骨坏死发生率为1%至9%，拔牙与放疗之间间隔21天可降低发生率，前提是不延误癌症治疗，且风险与剂量相关（<40 Gy时<6%；40至60 Gy之间为14%；>60 Gy时≥20%）。放射性骨坏死可自发发生（35%），大多累及下颌骨（85%）。
