DENTAL PRESERVATION IN PATIENTS IRRADIATED FOR HEAD AND NECK TUMORS A 10 YEAR EXPERIENCE WITH TOPICAL FLUORIDE AND A RANDOMIZED TRIAL BETWEEN 2 FLUORIDATION METHODS
DENTAL PRESERVATION IN PATIENTS IRRADIATED FOR HEAD AND NECK TUMORS A 10 YEAR EXPERIENCE WITH TOPICAL FLUORIDE AND A RANDOMIZED TRIAL BETWEEN 2 FLUORIDATION METHODS
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DOI：
10.1016/s0167-8140(83)80009-7
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发表时间：
1983-01-01
影响因子：
5.7
通讯作者：
BRANSFIELD D
中科院分区：
文献类型：
--
作者：
HORIOT J C;SCHRAUB S;BRANSFIELD D
自1972年以来，935例头颈癌放疗患者的义齿经过精心选择并根据明确的标准，使用每日局部应用氟化钠凝胶的前瞻性计划进行保存。并给出了1-10年随访结果。4%的患者发生了弥漫性龋齿，1%的患者发生了骨坏死，这可能与牙齿保存有关。这些并发症都没有发生在仔细选择患者的情况下，也没有发生在保持程序依从性的情况下。在29例中进行了照射后拔牙，除1例外，所有病例均随后愈合。这种提取的外科技术进行了描述。1980年3月，启动了一项随机方案，将氟化钠凝胶与高含量氟化物牙膏（1350 ppm F-）的使用进行比较。220名患者入组。在12-36个月时。随访中，3%的患者使用氟化物凝胶，而11%的患者使用牙膏（P = 0.1）。没有一个病人坚持程序的指示失败，在任何一个手臂。保存牙齿的照射患者应该是规则，而不是例外，给予良好的牙齿条件前的治疗和病人的合作。每天涂氟凝胶5分钟是预防照射后龋齿最可靠的方法。如果临床医生和患者充分了解高氟牙膏的局限性，那么每天使用两次高氟牙膏是一种很好的替代方法。
Since 1972, the dentures of 935 patients irradiated for head and neck carcinoma have been preserved after careful selection and according to well-defined criteria, using a prospective program of daily applications of topical sodium fluoride gel. The results of 1-10 yr follow-up are given. Four percent of the patients developed a diffuse dental decay and 1% a bone necrosis which can be related to the dental preservation. None of these complications occurred with careful patient selections nor when program compliance was maintained. Post-irradiation dental extractions were performed in 29 cases with subsequent healing in all cases but one. The surgical technique of such extractions is described. In March 1980, a randomized protocol was activated to compare the use of the sodium fluoride gel to high content fluoride toothpaste (1350 ppm F-). Two hundred and twenty patients were entered. At 12-36 mo. follow-up, dental caries were observed in 3% of the patients receiving the fluoride gel as compared to 11% receiving the toothpaste (P = 0.1). None of the patients adhering to the program instructions failed in either arm. Preservation of teeth in irradiated patients should be the rule and not the exception, given good dental condition prior to treatment and patient cooperation. The 5 min daily application of fluoride gel is the most reliable method for prevention of post-irradiation dental caries. The twice daily use of high content fluoride toothpaste is a good alternative provided its limitations are well understood by the clinician and patient.