Abed Hassan
Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.
Saudi Dent J. 2023 Feb;35(2):125-132. doi: 10.1016/j.sdentj.2023.01.009. Epub 2023 Feb 1.
Replacement of missing teeth is not a straightforward task in head and neck cancer (HNC) patients post-radiotherapy. There is debate regarding the best way to care for these patients as it has been reported that using dentures by HNC patients after receiving treatment with radiotherapy might initiate the development of osteoradionecrosis.
This rapid review aimed to collate and compare the national and international guidelines for the use of dentures following radiotherapy for HNC patients.
Three steps were included in data collection of this rapid review (first step; identification of dental and relevant non-dental associations/societies, second step, identification of national and international guidelines regarding the dental management of HNC patients, and third step; identification of recommendations about the replacement of missing teeth in HNC patients).
In the 193 countries recognized by the United Nations, there were 238 relevant societies found, from those 175 confirmed that they do not have clear guidelines. Only 32 associations/societies (all in either Europe and North America) recommend guidelines for their dentists (N = 12 guidelines) about the dental management of HNC patients and show their position regarding the use of dentures for HNC patients after receiving treatment with radiotherapy.
There are very few guidelines and those that do exist differ, lack detail, and rarely go beyond routine advice. Accordingly, clear, detailed, and evidence-based guidelines are required to inform the management of patients with missing teeth following radiotherapy for HNC patients.
对头颈癌(HNC)放疗后的患者而言,缺失牙的修复并非易事。对于如何最佳护理这些患者存在争议,因为有报道称HNC患者在接受放射治疗后使用假牙可能会引发放射性骨坏死。
本快速综述旨在整理和比较国内外关于HNC患者放疗后使用假牙的指南。
本快速综述的数据收集包括三个步骤(第一步:确定牙科及相关非牙科协会/学会;第二步,确定关于HNC患者牙科管理的国内外指南;第三步;确定关于HNC患者缺失牙修复的建议)。
在联合国认可的193个国家中,共找到238个相关学会,其中175个确认没有明确的指南。只有32个协会/学会(均在欧洲和北美)为其牙医推荐了关于HNC患者牙科管理的指南(N = 12项指南),并表明了他们对HNC患者放疗后使用假牙的立场。
指南非常少,而且现有的指南存在差异、缺乏细节,并且很少超出常规建议。因此,需要清晰、详细且基于证据的指南,以为HNC患者放疗后缺失牙患者的管理提供依据。