Restorative Dentistry Department, School of Dentistry, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, United Kingdom; Institute of Clinical Sciences, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital site, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, United Kingdom.
Restorative Dentistry Department, School of Dentistry, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, United Kingdom.
J Dent. 2020 Jun;97:103350. doi: 10.1016/j.jdent.2020.103350. Epub 2020 May 1.
To gain a consensus from consultants in restorative dentistry about the types of teeth that should be extracted from head and neck cancer patients (HNC) pre-radiotherapy.
Literature- and clinician-informed questionnaires were emailed to an 'expert panel' of consultants (n = 24/28; 86%) in the United Kingdom (UK) and Ireland on three consecutive occasions (Delphi rounds). The results of Round 1 were used to revise the questionnaire that was distributed in Round 2, and this procedure was repeated for Round 3. During Rounds 2 and 3, participants were asked to indicate, on a 5-point Likert scale, their level of agreement with a series of statements on the types of teeth that should be extracted pre-radiotherapy. The target level of consensus for each statement was 70%.
In Round 2, there was consensus-agreement for 69 of 102 statements (i.e. ≥ 70% of participants rated 'agree' or 'strongly agree' to the relevant statement). Consensus agreement was also achieved for 20 of 28 statements in Round 3. Therefore, a total of 89 consensus statements are presented that illuminate the decision-making process for the pre-radiotherapy extraction of molar, premolar, and anterior teeth with periodontal pocketing, furcation disease, mobility, caries, tooth-wear, apical disease, or other pathology.
The statements represent the consensus professional views of participated consultants in restorative dentistry in the UK and Ireland regarding the types of teeth that should be extracted from HNC patients pre-radiotherapy. The results provide a platform for the development of future guidelines.
Pre-radiotherapy dental assessments for head and neck cancer patients are considered mandatory. This study presents different criteria that should be considered for the treatment planning of these patients in relation to pre-radiotherapy extractions, according to the collective consensus opinion of participated consultants in restorative dentistry in the UK and Ireland.
在英国和爱尔兰，就头颈部癌症（HNC）患者放疗前应拔除哪些牙齿类型达成修复牙科顾问的共识。
文献和临床医生提供的问卷连续三次（德尔菲轮次）通过电子邮件发送给英国和爱尔兰的顾问“专家小组”（n=24/28；86%）。第一轮的结果用于修改第二轮分发的问卷，然后对第三轮进行了重复。在第二轮和第三轮中，参与者被要求在 5 分李克特量表上对一系列关于放疗前应拔除哪些牙齿类型的陈述表示同意程度。每个陈述的目标共识水平为 70%。
在第二轮中，102 项陈述中有 69 项达成共识（即≥70%的参与者对相关陈述评为“同意”或“强烈同意”）。在第三轮中，也达成了 28 项陈述中的 20 项共识。因此，提出了总共 89 条共识陈述，阐明了对有牙周袋、分叉病变、松动、龋齿、牙齿磨损、根尖病变或其他病理的磨牙、前磨牙和前牙进行放疗前拔牙的决策过程。
这些陈述代表了英国和爱尔兰修复牙科顾问对 HNC 患者放疗前应拔除的牙齿类型的共识专业观点。研究结果为未来指南的制定提供了一个平台。
对头颈部癌症患者进行放疗前牙科评估被认为是强制性的。本研究提出了不同的标准，这些标准应根据英国和爱尔兰修复牙科顾问的集体共识意见，考虑到这些患者放疗前拔牙的治疗计划。
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