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OraRad Study Aids Understanding Of Head and Neck Cancers

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PHOTO COURTESY: LARS NEUMANN/ ISTOCK / GETTY IMAGES PLUS;

Data released by investigators for OraRad — a landmark, multicenter prospective cohort study examining oral complications after radiation therapy (RT) for head and neck cancer — show promise for improving early detection, treatment and outcomes. Notable findings include:

  • Despite comprehensive pre-RT dental management, 17.8% of teeth present at the start of therapy were lost within two years.
  • Radiation led to a striking increase in gingival recession, in a dose-dependent manner. The mean distance from the cementoenamel junction to the gingival margin decreased by 74% during the two-year study period. 
  • Exposed intraoral bone was diagnosed in 35 of the 572 participants (6.1%). A diagnosis of osteoradionecrosis was confirmed in 18 subjects (3.1%).
  • Stimulated salivary flow at six months was reduced to 37% of pre-RT levels. This was followed by a partial recovery in salivary flow, to 59% of pre-RT levels at 18 months.
  • There was a modest increase in caries within the first two years following RT. The mean score for decayed, missing and filled surfaces was 47.6 pre-RT, which increased to 51.9 at the 24-month follow-up visit. 

Noting that further study is needed, the OraRad team is optimistic these findings will help lead to new therapeutic approaches for this patient population. 

From Decisions in Dentistry. June 2022;8(6)8.

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