头颈部癌症患者放疗后牙周疾病的发生率：一项横断面研究。

Frequency of periodontal disease in head and neck cancer patients after radiation therapy: a cross-sectional study.

作者信息

Abou-Bakr Asmaa, Ahmed Enji, William Hany, Hassanein Fatma E A

机构信息

Oral Medicine and Periodontology, Faculty of Dentistry, Galala University, Suez, Egypt.

Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Giza, Egypt.

出版信息

BMC Oral Health. 2025 Jul 2;25(1):1008. doi: 10.1186/s12903-025-06391-7.

DOI:10.1186/s12903-025-06391-7

PMID:40604898

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12225212/

Abstract

BACKGROUND

Patients with head and neck cancer (HNC) receiving radiation therapy (RT) have complications affecting both general and dental health. While RT is effective against HNC, it negatively impacts oral tissues, including changes in periodontal attachment. This study aimed to evaluate the frequency of periodontal disease among HNC patients after RT in a sample of the Egyptian population, as well as to assess the associated risk factors.

MATERIALS AND METHODS

A prospective cross-sectional study was conducted on 189 HNC patients attending a radiation center in Cairo, Egypt. Eligible patients underwent a full periodontal examination including plaque index (PI), bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD). Subsequently, Clinical Oral Dryness Score (CODS), salivary flow rate and body mass index (BMI) were assessed to examine associations with periodontal health.

RESULTS

Periodontal disease was diagnosed in 183 (96.8%) HNC patients. Among them, 174 (95.08%) cases were diagnosed as periodontitis and 9 (4.9%) as gingivitis. The distribution of periodontitis different stages was as follows: Stage I was found in 21 (12.07%) cases, Stage II in 30 (17.24%), Stage III in 55 (31.61%), and Stage IV in 68 (39.08%). The correlation between the number of RT fractions and periodontal disease severity was not statistically significant (p = 0.837). However, there was a strong negative correlation between periodontitis stage and both body mass index (BMI) and salivary flow rate. In contrast, strong positive correlations were observed between periodontitis severity and RT dose, plaque percentage, and Clinical Oral Dryness Score (CODS).

CONCLUSIONS

The frequency of periodontitis in the studied sample of HNC patients post RT was 95.08%, reflecting a notably high burden. The most prevalent periodontitis stage was the severe form (Stage IV). Higher periodontitis severity was found to be positively associated with RT dose, plaque percentage, and CODS, suggesting factors to plan future investigation on preventive care in HNC patients. While causality cannot be inferred due to the study design, these findings could be useful in developing more effective clinical management strategies in future research.

TRIAL REGISTRATION

The study was retrospectively registered on 29/10/2024 at ClinicalTrials.gov (NCT06667362).

摘要

背景

接受放射治疗（RT）的头颈癌（HNC）患者会出现影响全身和口腔健康的并发症。虽然放疗对HNC有效，但它会对口腔组织产生负面影响，包括牙周附着的变化。本研究旨在评估埃及人群样本中HNC患者放疗后牙周疾病的发生率，并评估相关危险因素。

材料与方法

对189名前往埃及开罗一家放疗中心就诊的HNC患者进行了一项前瞻性横断面研究。符合条件的患者接受了全面的牙周检查，包括菌斑指数（PI）、探诊出血（BOP）、临床附着水平（CAL）和探诊袋深度（PPD）。随后，评估临床口腔干燥评分（CODS）、唾液流速和体重指数（BMI），以检查与牙周健康的关联。

结果

183名（96.8%）HNC患者被诊断患有牙周疾病。其中，174例（95.08%）被诊断为牙周炎，9例（4.9%）为牙龈炎。牙周炎不同阶段的分布如下：I期21例（12.07%），II期30例（17.24%），III期55例（31.61%），IV期68例（39.08%）。放疗分次次数与牙周疾病严重程度之间的相关性无统计学意义（p = 0.837）。然而，牙周炎阶段与体重指数（BMI）和唾液流速之间存在强烈的负相关。相反，牙周炎严重程度与放疗剂量、菌斑百分比和临床口腔干燥评分（CODS）之间存在强烈的正相关。

结论

在本研究的HNC患者放疗后样本中，牙周炎的发生率为95.08%，反映出负担明显较高。最常见的牙周炎阶段是重度形式（IV期）。发现较高的牙周炎严重程度与放疗剂量、菌斑百分比和CODS呈正相关，这为计划未来对HNC患者预防护理的研究提供了因素。由于研究设计无法推断因果关系，但这些发现可能有助于在未来研究中制定更有效的临床管理策略。