Factors Influencing the Survival Rate of Teeth and Implants in Patients after Tumor Therapy to the Head and Neck Region-Part 1: Tooth Survival

Abstract

We aimed to evaluate possible factors influencing the long-term survival of teeth after tumor therapy (TT) to the head and neck region with and without radiation. Between January 2019 and January 2020, patients who underwent TT for head and neck cancer and received dental treatment before and after TT at the Department of Prosthetic Dentistry of the Martin Luther University Halle-Wittenberg were enrolled in the study. Clinical examination with assessment of dental status and stimulated salivary flow rate (SFR) was performed and information about disease progression and therapy was retrieved from medical records. Of 118 patients (male: 70.3%; mean age: 63.2 ± 12.4 years), 95 received radiotherapy (RT), and 47 were administered radio-chemotherapy (RCT). The teeth of irradiated patients exhibited a lower 5-year survival probability (74.2%) than those of non-irradiated patients (89.4%). The risk of loss (RL) after RT increased with nicotine use, presence of intraoral defects, reduced SFR, RCT and regarding mandibular teeth, and decreased with crowning following TT. Lower SFR increased the RL even without RT. Consideration of patient's treatment history, individual risk profile, and clinical findings during the prosthetic planning phase could enable earlier, more targeted dental treatment after TT (e.g., timely crowning).

Keywords: head and neck cancer; radiation therapy; risk factors; tooth loss.

Figure 1

Cumulative survival of teeth in irradiated and non-irradiated patients.

Figure 2

Cumulative survival of teeth in irradiated patients depending on the tumor localization.