| Abstract [eng] |
Relevance of the problem and aim of the work: Head and neck cancer is the seventh most common malignancy worldwide and the incidence of oral cavity and pharyngeal cancers in Lithuania has nearly doubled between 2012 and 2024. Poor pre-treatment oral health may complicate oncological treatment and adversely affect therapeutic outcomes; however, the dental status of oral and maxillofacial cancer (OMC) patients in the Lithuanian population had not previously been evaluated. The aim of this study was to assess the dental status of OMC patients prior to oncological treatment at Vilnius University Hospital Zalgiris Clinic (VUHZC), with respect to demographic characteristics and tumour localisation. Material and the methods: A retrospective cross-sectional study was conducted by analysing anonymised panoramic radiographs of 390 adult patients diagnosed with primary oral and maxillofacial malignancies between 2012 and 2023. The following parameters were assessed: number of remaining teeth, DMFT index and its components, number of retained roots, prevalence of periapical periodontitis, and marginal alveolar bone loss measured using ImageJ software. Intra-observer agreement was established to ensure measurement reliability. Statistical analysis was performed using IBM SPSS 31.0, applying descriptive statistics, Mann–Whitney U, Kruskal–Wallis, and Chi-square tests. Results were considered statistically significant at p < 0.05. Results: Of the 390 patients examined, 49 (13.0%) were edentulous, of whom 34 (69.4%) were male and 15 (30.6%) female. The mean age of edentulous patients was 68.1 years (± 9.8), compared to 60.3 years (± 12.7) among dentate patients. Dental status was assessed in 122 (35.8%) women and 219 (64.2%) men. The median number of remaining teeth was 17 [13.5], decayed teeth – 4 [5.0], filled teeth – 2 [5.0], missing teeth – 12 [14.0], and the DMFT index – 23 [8.5], which was identical between sexes. A statistically significant difference was found between the sexes in the filled teeth component: women (M = 4 [8.3]) had a significantly higher number of filled teeth than men (M = 1 [3.0]) (p < 0.001). Men (M = 1 [4.0]) had a significantly greater number of retained roots than women (M = 0 [1.0]) (p < 0.001) and a greater number of decayed teeth (M = 5 [6.0]) (p = 0.014). The highest number of retained roots was observed in patients with floor of mouth cancer, significantly exceeding the values of most other tumour localisations (p < 0.05). Periodontitis of any severity was detected in 97% of patients, with 69.6% diagnosed with stage III–IV periodontitis. The mean overall bone loss was 32.9% [17.7] and was significantly greater in male patients (p < 0.05). Conclusions: The dental status of OMC patients prior to oncological treatment was poor. Although overall caries intensity did not differ between sexes, women had a significantly higher number of filled teeth, while men had a greater number of decayed teeth and retained roots, indicating a higher pre-treatment oral rehabilitation need in the latter group. Clinically significant marginal alveolar bone loss was identified in nearly all patients, while patients with floor of mouth cancer were distinguished by the highest number of retained roots, reflecting the greatest degree of oral neglect and rehabilitation need within this subgroup. Keywords: oral cancer, panoramic radiographs, dental status, DMFT index, periodontitis. |
