Pre-radiotherapy dental extractions in patients with head and neck cancer: a Delphi study. (June 2020)

• Record Type: Journal Article
• Authors: Moore, Ciaran; McLister, Conor; O'Neill, Ciaran; Donnelly, Michael; McKenna, Gerald
• Is Part Of: Journal of dentistry. Volume 97(2020:Jun.)
• Publication Date: 2020-06
• Subjects: BSSPD British Society of Prosthodontics -- HNC head and neck cancer -- IMRT intensity modulated radiotherapy -- IQR interquartile range -- M median -- ORN osteoradionecrosis -- P percentage agreement -- QoL quality of life -- QUB Queen's University Belfast -- S standard deviation -- UK United Kingdom -- X mean; Head and neck neoplasms -- Radiotherapy -- Dental caries -- Periodontal disease -- Tooth extraction -- Oral health; Dentistry -- Periodicals; Dentistry -- Periodicals; Dentisterie -- Périodiques; Electronic journals; 617.6005
• DOI: 10.1016/j.jdent.2020.103350
• Languages: English
• ISSNs: 0300-5712

Abstract

Highlights: This Delphi study collated 'expert' opinion regarding pre-radiotherapy dental extractions. Consensus statements outline the types of teeth that should be extracted pre-radiotherapy. It is envisaged that the study's results will help to inform the development of new guidelines. Abstract: Objectives: To gain a consensus from consultants in restorative dentistry about the types of teeth that should be extracted from head and neck cancer patients (HNC) pre-radiotherapy. Materials: Literature- and clinician-informed questionnaires were emailed to an 'expert panel' of consultants (n = 24/28; 86%) in the United Kingdom (UK) and Ireland on three consecutive occasions (Delphi rounds). The results of Round 1 were used to revise the questionnaire that was distributed in Round 2, and this procedure was repeated for Round 3. During Rounds 2 and 3, participants were asked to indicate, on a 5-point Likert scale, their level of agreement with a series of statements on the types of teeth that should be extracted pre-radiotherapy. The target level of consensus for each statement was 70%. Results: In Round 2, there was consensus-agreement for 69 of 102 statements (i.e. ≥ 70% of participants rated 'agree' or 'strongly agree' to the relevant statement). Consensus agreement was also achieved for 20 of 28 statements in Round 3. Therefore, a total of 89 consensus statements are presented that illuminate the decision-making process for the pre-radiotherapy extraction of molar, premolar, and anterior teeth with periodontal pocketing, furcation disease, mobility, caries, tooth-wear, apical disease, or other pathology. Conclusion: The statements represent the consensus professional views of participated consultants in restorative dentistry in the UK and Ireland regarding the types of teeth that should be extracted from HNC patients pre-radiotherapy. The results provide a platform for the development of future guidelines. Clinical Significance: Pre-radiotherapy dental assessments for head and neck cancer patients are considered mandatory. This study presents different criteria that should be considered for the treatment planning of these patients in relation to pre-radiotherapy extractions, according to the collective consensus opinion of participated consultants in restorative dentistry in the UK and Ireland.