Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph?
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...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
|
| Series: | Dentistry Journal |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2304-6767/11/5/122 |
| _version_ | 1797600509135159296 |
|---|---|
| author | Judith A. E. M. Zecha Alexa M. G. A. Laheij Judith E. Raber-Durlacher Anneke M. Westermann Jan de Lange Ludwig E. Smeele |
| author_facet | Judith A. E. M. Zecha Alexa M. G. A. Laheij Judith E. Raber-Durlacher Anneke M. Westermann Jan de Lange Ludwig E. Smeele |
| author_sort | Judith A. E. M. Zecha |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T03:49:05Z |
| format | Article |
| id | doaj.art-d4b271ef043a4cc88fc92cb6333e78d7 |
| institution | Directory Open Access Journal |
| issn | 2304-6767 |
| language | English |
| last_indexed | 2024-03-11T03:49:05Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Dentistry Journal |
| spelling | doaj.art-d4b271ef043a4cc88fc92cb6333e78d72023-11-18T01:02:48ZengMDPI AGDentistry Journal2304-67672023-05-0111512210.3390/dj11050122Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph?Judith A. E. M. Zecha0Alexa M. G. A. Laheij1Judith E. Raber-Durlacher2Anneke M. Westermann3Jan de Lange4Ludwig E. Smeele5Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, 1081 LA Amsterdam, The NetherlandsDepartment of Oncology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsDepartment of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The NetherlandsBackground: 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.https://www.mdpi.com/2304-6767/11/5/122oral focidental focal infectionfebrile neutropeniadental screeningpanoramic radiographcancer chemotherapy |
| spellingShingle | Judith A. E. M. Zecha Alexa M. G. A. Laheij Judith E. Raber-Durlacher Anneke M. Westermann Jan de Lange Ludwig E. Smeele Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph? Dentistry Journal oral foci dental focal infection febrile neutropenia dental screening panoramic radiograph cancer chemotherapy |
| title | Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph? |
| title_full | Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph? |
| title_fullStr | Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph? |
| title_full_unstemmed | Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph? |
| title_short | Pre-Chemotherapy Dental Screening: Is There Additional Diagnostic Value for a Panoramic Radiograph? |
| title_sort | pre chemotherapy dental screening is there additional diagnostic value for a panoramic radiograph |
| topic | oral foci dental focal infection febrile neutropenia dental screening panoramic radiograph cancer chemotherapy |
| url | https://www.mdpi.com/2304-6767/11/5/122 |
| work_keys_str_mv | AT judithaemzecha prechemotherapydentalscreeningisthereadditionaldiagnosticvalueforapanoramicradiograph AT alexamgalaheij prechemotherapydentalscreeningisthereadditionaldiagnosticvalueforapanoramicradiograph AT juditheraberdurlacher prechemotherapydentalscreeningisthereadditionaldiagnosticvalueforapanoramicradiograph AT annekemwestermann prechemotherapydentalscreeningisthereadditionaldiagnosticvalueforapanoramicradiograph AT jandelange prechemotherapydentalscreeningisthereadditionaldiagnosticvalueforapanoramicradiograph AT ludwigesmeele prechemotherapydentalscreeningisthereadditionaldiagnosticvalueforapanoramicradiograph |