Assessment of periodontal changes in patients undergoing radiotherapy for head and neck malignancy: a hospital-based study

Abstract

Background: Surgical resection, radio and chemotherapy, either used singly or in combination, are the three most common modalities used in head and neck cancer treatment. These modalities are effective in eradicating the tumor; they also negatively impact the normal head and neck structures surrounding the tumor. Direct damage to the oral structures (soft and hard tissue) frequently occurs from radio and chemotherapy, and indirect damage may also arise from systemic toxicity.

Materials and methods: This prospective study was designed to analyze the effect of radiotherapy on periodontal parameters in oncology patients prior to irradiation in the head and neck area, compared with 6 months following treatment. The statistical analysis was done using SPSS.

Results: The study sample consisted of total 29 patients of head and neck malignancy (M = 17, F = 12), of mean age 45.66 years. Only 22% of patients had various habits (smoking, tobacco chewing, and alcohol consumption) and majority (27.59% patients) had tongue malignancy. All periodontal parameters - oral hygiene index Siller (OHIS), clinical attachment level (CAL), gingival recession (GR), except probing pocket depth (PPD) - were significantly increased after radiotherapy. When comparison was made between doses and fractions, only in mandible statistically significant difference were observed in GR.

Conclusion: Although there was no significant change in PPD, there was increased GR, CAL, and plaque index associated with radiotherapy. In this study, 61.5% cases of mandibular teeth and 34.4% cases of maxillary teeth showed attachment loss greater than 0.2 mm. So, all patients with head and neck malignancy should undergo an oral examination before the initiation of cancer therapy with adequate prophylaxis.