An evaluation of feasibility of dental extraction in head and neck cancer patients Less than 3 yeas after irradiation

Objective:To investigates the feasibility of dental extraction in head and neck cancer patients less than 3 years after radiation therapy Method:During 2001- 2002 years patients suffered from head and neck cancer need tooth extraction after irradiated less than 3 years, were selected. All patients underwent radiation in routine fraction(1.8-2.0 Gy per fraction). Before tooth extraction, it is necessary to take an tooth X ray to confirm that the bone tissue around the disease tooth had no obviously damaged and estimate the absorbed dose on irradiated alveolar bone by radiation Therapy Plan System °°(TPS). And antibacterial drugs were given before and after tooth exaction for at least 3 days .The bigger wounds were tight sewing up. The difficulty of tooth extraction was divided into: Easy, general and difficult.Results:Total extracted teeth were 82. The range in age was from 44 to79 yeas,(median 59 yeas). There were 74 teeth extracted easily; 5 teeth extracted general and 3 teeth difficult. The average time from the end of radiation therapy to teeth extracted were 25.34±1.69 months, (range 2 weeks to 36 months). Except one impacted tooth with pain for one week after tooth extracted, all dental extractions have no complication. All incises healed well, no osteoradionecrosis and dry socket occurred at all. The average tumor dose were 61.01±6.04 Gy,(range 70.00 Gy to 55.00 Gy)°£The average involved teeth dose were 28.07±19.03 Gy (range 63.00 Gy to 2.10 Gy)°£The doses among involved teeth were greatly different. The average doses ratio between involed teeth and tumor was 46.99±32.64% (range 3% to 100%).conclusions:Along with the evolution of radiation equipment, the teeth dose could be estimated by TPS. The doses between tumor and teeth were significently difference, p°Ü0.001. The tumor dose could not be regard as the dose of teeth. And the doses among the teeth were also difference.