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Journal of Stomatology Oral and Maxillofacial Surgery
Volume 119, n° 1
pages 2-7 (février 2018)
Doi : 10.1016/j.jormas.2017.09.004
Received : 11 May 2017 ;  accepted : 4 September 2017
Original Articles

Upper aerodigestive tract cancer and oral health status before radiotherapy: A cross-sectional study of 154 patients
 

A. Raskin a, b, c, , M. Ruquet a, b, c, L. Weiss-Pelletier b, J. Mancini d, e, f, O. Boulogne d, e, f, J. Michel c, d, g, N. Fakhry d, g, J.M. Foletti d, C. Chossegros d, g, R. Giorgi d, e, f
a Faculté d’odontologie, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France 
b Pôle d’odontologie, UF des soins spécifiques, hôpital de la Timone, Assistance publique–Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France 
c EFS CNRS, faculté de médecine, UMR 7268 ADES, Aix-Marseille université, 51, boulevard Pierre-Dramard, 13944 Marseille cedex 15, France 
d Faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13355 Marseille cedex 5, France 
e Pôle de santé publique BIOSTIC, service biostatistique et technologies de l’information et de la communication, hôpital de la Timone, Assistance publique–Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France 
f SESSTIM sciences économiques et sociales de la santé et traitement de l’information médicale, UMR 912 Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean-Moulin, 13385 Marseille cedex 5, France 
g Pôle PROMO, service ORL et chirurgie cervico-faciale, hôpital de la conception, Assistance publique–Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France 

Corresponding author. Pôle d’odontologie – UF des soins spécifiques, hôpital de la Timone 1, Assistance publique–Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Abstract
Objectives

We aimed to determine primarily the oral health status of patients with upper aerodigestive tract cancer before radiotherapy, and secondarily the prevalence of risk factors for poor oral status.

Methods

A cross-sectional study was conducted in Marseille University hospital. Assessment criteria were the Decay, Missing and Filled (DMF) Index and periodontal status.

Results

One hundred and fifty-four patients, mean age 60.9years, were included. The most common sites of primary tumors were the larynx (28.6%) and oral cavity (26.6%). Current or past smokers accounted for 80.5% of patients and 67% were alcohol abusers. Most patients (83.8%) did not have xerostomia. They ate three meals a day (61%), with sugar consumption in 40%. The median number of daily tooth brushings was 2, with a manual toothbrush (81.2%). Few patients used dental floss or interproximal brushes. Individual DMF index was 17.6 (D =2.3, M =9.3, F =6.0) and was higher in patients with xerostomia and alcohol abusers (P =0.01). Osseous level was 62.3% and 57.8% of patients had osseous infections, which were more common with poor hygiene (P =0.04). Most patients (85.7%) had periodontal disease, but incidence did not significantly differ according to risk factors.

Discussion

The DMF index was higher in presence of periodontal disease and osseous infections. Alcohol and xerostomia were associated with a high individual DMF index and osseous infections were more frequent in patients with poor hygiene. Patients with upper aerodigestive tract cancer are at high risk of osteoradionecrosis if they do not receive dental treatment before radiotherapy.

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Keywords : Upper aerodigestive tract cancer, Radiotherapy, DMF index, Periodontal status




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