Harris J. Keene

Salivary flow rates in patients with head and neck cancer 0. 5 to 25 years after radiotherapy

In this clinical study at the University of Texas M. D. Anderson Cancer Center, unstimulated and stimulated salivary flow rates were obtained from 47 patients with head and neck cancer who had received mantle, unilateral facial, or bilateral facial field radiotherapy from 0.5 to 25 years earlier. The magnitude of salivary flow rate reduction compared with a healthy control group was primarily related to the radiation dosage and the amount of salivary gland tissue included in the irradiated fields. Flow rates were lower for women in all groups, but these differences were not statistically significant.

Prevalence of caries-associated microflora after radiotherapy in patients with cancer of the head and neck

In this clinical study of irradiated head and neck cancer patients at M. D. Anderson Hospital, 68 adult xerostomic patients using different fluoride gels were evaluated for oral levels of Lactobacillus and Streptococcus mutans during the postradiotherapy period, which ranged from 2 months to 20 years. The fluoride groups were compared with a control group consisting of 21 cancer patients who were scheduled to undergo radiotherapy. Lactobacillus levels were significantly elevated in all postradiotherapy groups, irrespective of the type of fluoride gel used. S. mutans levels in the 0.4% SnF2 group were significantly lower than in the 1.0% NaF gel group. The low levels of S. mutans observed in the SnF2 group suggest that this agent may be exerting a downward selective pressure on the microorganism during the postradiotherapy period.

MULTIPLE MORPHOLOGIC DENTAL ANOMALIES. REPORT OF A CASE.

Abstract The interesting display of dental anomalies in the case reported here is an excellent example of the profound morphogenetic effect that suppressive influences may have on the process of odontogenesis. The mechanism by which the reductions occurred appears to be partly related to multiple invaginations and extrusions of the odontogenic apparatus during morphodifferentiation. However, the initiating factor or factors responsible for this unusual behavior remains obscure.

Effect of radioactive iodine therapy on salivary flow rates and oral Streptococcus mutans prevalence in patients with thyroid cancer

Unstimulated and stimulated salivary flow rates, Streptococcus mutans samples, and dental caries data were obtained from 50 patients with thyroid cancer who had received radioactive iodine, I131, from 0.3 to 20 years earlier. The salivary flow rates were compared with a healthy control group, and the S. mutans counts were compared to a group of patients with head and neck cancer who were sampled before radiotherapy. Flow rates were found to be significantly lower in the patients with thyroid cancer, and S. mutans levels were slightly but not significantly higher than the controls. Longitudinal flow rate data taken on four patients, who served as their own controls before and after I131 therapy, indicated a trend in saliva reduction.

Cariogenic microflora in patients with Hodgkin's disease before and after mantle field radiotherapy

Because mantle field radiotherapy is associated with partial xerostomia in patients with Hodgkins disease, the purpose of this study was to evaluate their cariogenic microflora before and after completion of radiotherapy. We obtained samples of oral saline solution rinse from 40 patients with Hodgkins disease before radiotherapy and from 31 patients with Hodgkins disease who had survived 1 to 24 years after radiotherapy. We also evaluated caries experience and history of fluoride gel use for caries prevention in these patients. Mutans streptococci and lactobacilli levels were significantly higher in the postradiotherapy patients with carious teeth, particularly in those with limited home use of fluoride gels. In the postradiotherapy group, caries parameters were significantly higher (p < 0.05) than in the preradiotherapy group. Within the postradiotherapy group, both caries and microbial parameters tended to be higher in patients who were less compliant about using the recommended 0.4% stannous fluoride brush-in technique than in those who used the gel regularly at home. This study indicates that for patients with Hodgkins disease who receive mantle field irradiation during the management of their disease, a sustained brush-in program with stannous fluoride gel can be of benefit for caries prevention and for limitation of oral levels of cariogenic mutans streptococci.