Case-control study of oral disease indexes in individuals with head and neck cancer after antineoplastic therapy

Quispe, Reyna Aguilar; Cremonesi, Adrielle Lindolpho; Gonçalves, Jeanne Kelly; Rubira, Cassia Maria Fischer; Santos, Paulo Sérgio da Silva

doi:10.1590/S1679-45082018AO4245

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ORIGINAL ARTICLE • Einstein (São Paulo) 16 (3) • 2018 • https://doi.org/10.1590/S1679-45082018AO4245 copy

Case-control study of oral disease indexes in individuals with head and neck cancer after antineoplastic therapy

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To evaluate the oral health of patients with head and neck cancer after antineoplastic treatment, and to compare them with patients with no history of cancer.

Methods

A total of 75 patients, divided into Study Group, composed of individuals after antineoplastic treatment (n=30), and Control Group, with individuals with no history of cancer (n=45), aged 37 to 79 years. The oral health status was evaluated through the index of decayed, missing or filled permanent teeth (DMFT), community periodontal index and evaluation of the use and need of prosthesis. All of these items were evaluated according to the criteria recommended by the World Health Organization. The statistical analysis was descriptive and used the Pearson’s χ² test.

Results

The community periodontal index was higher in the Study Group when compared to the Control Group (p<0.0001). The need for an upper (p<0.001) and lower (p<0.0001) prostheses was higher in the Study Group. Also, the use of upper prosthesis was higher in the Study Group (p<0.002). The missing or filled permanent teeth index between the two groups (p>0.0506) and the use of lower prosthesis (p>0.214) did not present a relevant statistical difference.

Conclusion

Periodontal disease and edentulism are the most significant changes in individuals who received antineoplastic therapy for head and neck cancer as well as greater need for oral rehabilitation.

Dental caries; Periodontal diseases; Mouth rehabilitation; Head and neck neoplasms/drug therapy; Radiotherapy

Patient	Sex	Age	Type of cancer	Surgery	Radiotherapy	Chemotherapy	Time after treatment
1	Male	35	Nasopharynx	Yes	Yes	No	4 years and 9 months
2	Male	41	Amygdala	No	Yes	Yes	3 months
3	Male	42	Amygdala	Yes	Yes	Yes	7 months
4	Male	45	Amygdala	No	Yes	Yes	1 month
5	Male	46	Tonsillar pillar	No	Yes	Yes	1 year and 1 month
6	Male	49	Hypophysis	No	Yes	Yes	15 years
7	Male	51	Tonsillar fossa	Yes	Yes	Yes	4 months
8	Female	52	Mucoepidermoid	Yes	No	No	2 years and 2 months
9	Male	52	Tongue	No	Yes	Yes	4 months
10	Male	52	Floor of the mouth	No	Yes	Yes	1 year and 4 months
11	Male	55	Tongue	Yes	Yes	No	10 months
12	Male	57	Tongue	No	Yes	Yes	1 year
13	Male	59	Nasopharynx	Yes	Yes	Yes	2 years and 5 months
14	Male	60	Larynx	Yes	Yes	No	1 year
15	Male	61	Larynx	Yes	Yes	No	9 years and 5 months
16	Male	61	Gingiva	Yes	No	No	3 months
17	Male	62	Vocal folds	Yes	Yes	No	2 months
18	Male	63	Amygdala	Yes	Yes	No	1 year and 11 months
19	Male	64	Tongue	Yes	Yes	Yes	1 year and 5 months
20	Male	65	Floor of the mouth	Yes	Yes	No	2 years
21	Female	65	Adenoid	Yes	Yes	No	9 months
22	Female	69	Osteosarcoma	Yes	Yes	No	2 years and 9 months
23	Male	70	Tongue	Yes	Yes	No	6 months
24	Female	72	Gingiva	Yes	Yes	Yes	2 months
25	Male	73	Tongue	No	Yes	Yes	1 month
26	Male	74	Lip	Yes	No	Yes	1 year and 2 months
27	Female	77	Tongue mucosa	Yes	Yes	Yes	5 months
28	Male	78	Larynx	No	Yes	Yes	4 months
29	Male	79	Tonsillar pillar	Yes	Yes	Yes	7 months
30	Male	79	Vocal folds	Yes	Yes	No	7 years

Criteria	SG	CG
Criteria	n (%)	n (%)
Healthy	1 (3.3)	18 (40)
Bleeding observed, directly or by using a mouth mirror, after probing	4 (13.3)	8 (8)
Calculus (any amount)	10 (33.3)	10 (22.2)
4 to 5mm pocket	8 (26.7)	0 (0)
6mm or larger pocket	1 (3.3)	0 (0)
When less than two functional teeth are present	3 (10)	9 (20)
Excluded sextant	3 (10)	0 (0)
Total	30 (100)	45 (100)
Pearson’s χ² test	30.863
p value*	<0.0001

Criteria	Upper		Lower

	SG	CG	SG	CG
	n (%)	n (%)	n (%)	n (%)
Does not use dental prosthesis	12 (40)	39 (86.7)	24 (80)	41 (91.1)
Uses a fixed bridge	4 (13.3)	2 (4.4)	1 (3.3)	0 (0)
Uses more than one fixed bridge	6 (20)	1 (2.2)	4 (13.3)	1 (2.2)
Uses a removable partial denture	1 (3.3)	1 (2.2)	1 (3.3)	2 (4.4)
Uses one or more fixed bridges and one removable partial denture	1 (3.3)	0 (0)	0 (0)	0 (0)
Uses a complete denture prosthesis	6 (20)	2 (4.4)	0 (0)	1 (2.2)
No information	0 (0)	0 (0)	0 (0)	0 (0)
Total	30 (100)	45 (100)	30 (100)	45 (100)
Pearson’s χ² test	19.304		5.812
p value*	<0.002		<0.214

Criteria	Upper		Lower

	SG	CG	SG	CG
	n (%)	n (%)	n (%)	n (%)
Does not need dental prosthesis	9 (30)	35 (77.8)	1 (3.3)	35 (77.8)
Needs a dental prosthesis to replace one element	3 (10)	2 (4.4)	0 (0)	4 (8.9)
Needs a dental prosthesis to replace more than one element	10 (33.3)	3 (6.7)	21 (70)	2 (4.4)
Needs a combination of dental prosthesis	4 (13.3)	1 (2.2)	1 (3.3)	1 (2.2)
Needs a complete denture prosthesis	4 (13.7)	3 (6.7)	7 (23.3)	3 (6.7)
No information	0 (0)	1 (2.2)	0 (0)	0 (0)
Total	30 (100)	45 (100)	30 (100)	45 (100)
Pearson’s χ² test	20.079		52.507
p value*	<0.001		<0.0001

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[1] Corresponding author: Paulo Sérgio da Silva Santos. Rua Dr. Octavio Pinheiro Brisolla, 9-75 Vila Universitária Zip code: 17012-901 – Bauru, SP, Brazil Phone: (55 14) 3235-8000 E-mail: paulosss@fob.usp.br