Radiographic changes on panoramic imaging following intensity-modulated radiation therapy

Area of Science:

• Dental Radiology
• Oncology
• Radiation Therapy

Background:

• Oropharyngeal cancer treatment often involves radiation therapy.
• Intensity-modulated radiation therapy (IMRT) is a common radiation technique.
• Radiographic changes in the jaw following IMRT require documentation.

Purpose of the Study:

• To document radiographic changes on panoramic radiographs after IMRT.
• To assess the impact of IMRT on mandibular and maxillary structures.

Main Methods:

• Retrospective study of 143 oropharyngeal cancer patients treated with IMRT.
• Evaluation of pre-IMRT and post-IMRT panoramic radiographs (286 total).
• Analysis of radiographic changes in the maxilla and mandible.

Main Results:

• No significant radiographic changes were observed in the maxilla post-IMRT.
• Significant mandibular changes included periodontal ligament space widening and vertical defects on the ipsilateral side.
• No significant association found between other specific bone loss patterns and ipsilateral IMRT.

Conclusions:

• Subclinical radiographic changes in the mandible are common after IMRT.
• These changes indicate periodontium devitalization and necessitate close dental monitoring.
• Frequent dental recalls are crucial to minimize risks of oral surgery complications and osteoradionecrosis.