Occurrence, extension, and severity of the periodontal disease in patients to be submitted to radiotherapy and/ or chemotherapy
Keywords:
Periodontics, Oncology Service, Pretreatment, Radiation Oncology, Drug TherapyAbstract
The purpose of this study was to assess the occurrence, extension, and severity of periodontal disease (PD) in oncologic patients prior to undergoing therapy to treat cancerous tumors. The variables investigated from the analysis of medical files and periodontal examinations included gender, age, tobacco consumption, type and location of the tumor, oncologic therapy, the presence of systemic disease, and clinical attachment loss (CAL). The results were submitted to statistical analysis, comparing the individual means of CAL. Thirty-seven patients were evaluated, with a prevalence of white males, under 60 years of age, who were smokers and presented no systemic diseases. The predominant tumor was squamous cell carcinoma (91.9%). Only in one patient was the tumor not located in the head and neck region. Radiotherapy, therefore, was the predominant recommended treatment (70.3%). PD was found in all evaluated patients, and a generalized and moderate prevalence pattern (94.6% and 40.6%, respectively) could be observed. In addition, the means of CAL were significantly greater in patients with systemic diseases. The PD present prior to oncologic therapy could be found in all evaluated patients. The characterization of the occurrence, extension, and severity of the PD prior to oncologic treatment can aid in improving basic oral care, aimed at reducing the prevalence of severe oral consequences that these patients tend to undergo.
Downloads
References
Genco RJ. Current view of risk factors for periodontal diseases. J Periodontol. 1996; 67(Supl,10):1041-9.
Beckstrom BW, Horsley SH, Scheetz JP et al. Correlation between carotid area calcifications and periodontitis: a retrospective study of digital panoramic radiographic findings in pretreatment cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103:359-66.
Brown LJ, Oliver RC, Loe H. Periodontal diseases in the U.S. in 1981: prevalence, severity, extent, and role in tooth mortality. J Periodontol. 1989; 60:363-70.
Saba-Chujfi E, Santos-Pereira SA, Saba ME. Opções cirúrgicas na terapia da bolsa periodontal. In: Cardoso RJA, Gonçalves EAN. Periodontia/ Cirurgia para Implantes/Cirurgia/Anestesiologia. São Paulo: Artes Médicas, 2002:121-36.
Pussinen PJ, Mattila K. Periodontal infections and atherosclerosis: mere associations? Curr Opin Lipidol. 2004; 15:583-8.
Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J, Hingorani AD, Vallance P, Deanfield J. Treatment of periodontitis and endothelial function. N Engl J Med. 2007; 356:911-20.
Amar S, Gokce N, Morgan S, Loukideli M, Van Dyke TE, Vita JA. Periodontal disease is associated with brachial artery endothelial dysfunction and systemic inflammation. Arterioscler Thromb Vasc Biol. 2003; 23:1245-9.
Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease, and stroke. A systematic review. Ann Periodontol. 2003; 8:38-53.
Reynolds MA, Minah GE, Peterson DE et al. Periodontal disease and oral microbial successions during my elosuppressive cancer chemotherapy. J Clin Periodontol. 1989; 16:185-9.
Peterson DE. Pretreatment strategies for infection prevention in chemotherapy patients. NCI Monogr. 1990; 9:61-71.
Epstein JB, Lunn R, Le N, Stevenson-Moore P. Periodontal attachment loss in patients after head and neck radiation therapy. Oral Surg Oral Med Oral Pathol Radiol Endod. 1998; 86:673-7.
Nemeth Z, Somogyi A, Takacsi-Nagy Z, Barabas J, Nemeth G, Szabo G. Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity. Pathol Oncol Res. 2000; 6:53-8.
Souza EW, Barbosa JRA. Procedimentos odontológicos em pacientes submetidos a radioterapia de cabeça e pescoço. Odontol Mod. 1991; 18:23-5.
Oliveira LR, Ribeiro-Silva A, Zucoloto S. Perfil da incidência e da sobrevida de pacientes com carcinoma epidermóide oral em uma população brasileira. J Bras Patol Med Lab. 2006; 42:385-92.
Lindhe J. Tratado de periodontia clínica e implantologia oral. 4 ed. Rio de Janeiro: Guanabara Koogan, 2005.
Lindhe J, Ranney R, Lamster I, Charles A, Chung C, Flemmig T et al. Consensus report: chronic periodontitis. Ann Periodontol. 1999; 4: 38.
Lockhart PB, Clark J. Pretherapy dental status of patients with malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol Radiol Endod.1994; 77:236-41.
Slots J. Casual or causal relationship between periodontal infection and non-oral disease? J Dent Res.1998; 77:1764-5.
Lopez-Galindo MP, Bagan JV, Jimenez-Soriano Y, Alpiste F, Camps C. Clinical evaluation of dental and periodontal status in a group of oncological patients before chemotherapy. Med Oral Patol Oral Cir Bucal. 2006; 11: E17-21.
