TY - JOUR
T1 - Pre-Chemotherapy Dental Screening
T2 - Is There Additional Diagnostic Value for a Panoramic Radiograph?
AU - Zecha, Judith A. E. M.
AU - Laheij, Alexa M. G. A.
AU - Raber-Durlacher, Judith E.
AU - Westermann, Anneke M.
AU - de Lange, Jan
AU - Smeele, Ludwig E.
N1 - Publisher Copyright: © 2023 by the authors.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: The oral cavity is a potential source of infectious complications in patients treated with myelosuppressive chemotherapy (CT). Pre-chemotherapy oral examination to identify foci of infection is recommended, but it is unclear whether this should include panoramic radiography. The present study aimed to evaluate the additional diagnostic merit of panoramic radiography as part of pre-CT oral screening. Methods: Patients with solid tumors scheduled to receive a myelosuppressive CT were eligible. The foci definition followed the guidelines of the Dutch Association of Maxillofacial Surgery. Oral foci assessed by clinical evaluation and panoramic radiography were compared. Results: In 33 out of 93 patients (35.5%), one or more foci were identified by clinical examination, whereas in 49.5% of patients, panoramic radiography showed pathology. In 19 patients, an oral focus was missed by clinical examination only, whereas in 11 patients, panoramic radiography indicated periodontal bone loss, but advanced periodontitis was not substantiated by clinical examination. Conclusions: Panoramic radiographs complement clinical examinations and have additional diagnostic value. Nevertheless, the additional merit seems small, and the clinical relevance may vary depending on the anticipated risk of developing oral complications and the need for detailed diagnosis and rigorous elimination of oral foci prior to the start of cancer therapy.
AB - Background: The oral cavity is a potential source of infectious complications in patients treated with myelosuppressive chemotherapy (CT). Pre-chemotherapy oral examination to identify foci of infection is recommended, but it is unclear whether this should include panoramic radiography. The present study aimed to evaluate the additional diagnostic merit of panoramic radiography as part of pre-CT oral screening. Methods: Patients with solid tumors scheduled to receive a myelosuppressive CT were eligible. The foci definition followed the guidelines of the Dutch Association of Maxillofacial Surgery. Oral foci assessed by clinical evaluation and panoramic radiography were compared. Results: In 33 out of 93 patients (35.5%), one or more foci were identified by clinical examination, whereas in 49.5% of patients, panoramic radiography showed pathology. In 19 patients, an oral focus was missed by clinical examination only, whereas in 11 patients, panoramic radiography indicated periodontal bone loss, but advanced periodontitis was not substantiated by clinical examination. Conclusions: Panoramic radiographs complement clinical examinations and have additional diagnostic value. Nevertheless, the additional merit seems small, and the clinical relevance may vary depending on the anticipated risk of developing oral complications and the need for detailed diagnosis and rigorous elimination of oral foci prior to the start of cancer therapy.
KW - cancer chemotherapy
KW - dental focal infection
KW - dental screening
KW - febrile neutropenia
KW - oral foci
KW - panoramic radiograph
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U2 - https://doi.org/10.3390/dj11050122
DO - https://doi.org/10.3390/dj11050122
M3 - Article
C2 - 37232773
SN - 2304-6767
VL - 11
SP - 1
EP - 11
JO - Dentistry Journal
JF - Dentistry Journal
IS - 5
M1 - 122
ER -