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Mandibular changes on panoramic imaging after head and neck radiotherapy: a commentary

Published:August 18, 2016DOI:https://doi.org/10.1016/j.oooo.2016.07.027
      To the Editor:
      We read with great interest the recently published article by Chan et al. titled “Mandibular changes on panoramic imaging after head and neck radiotherapy.”
      • Chan K.C.
      • Perschbacher S.E.
      • Lam E.W.N.
      • et al.
      Mandibular changes on panoramic imaging after head and neck radiotherapy.
      We would like to congratulate the authors for their original study, as there are no published case series that characterize the different types of radiographic changes in the jaws post radiotherapy. However, we had a few queries and would appreciate if the authors could provide further clarification:
      • 1.
        It is not clear why patients with osteoradionecrosis were excluded from the study, as it was not defined in the study's exclusion criteria.
      • 2.
        We had a little difficulty understanding how the bone changes can be attributed to radiotherapy alone. In the study there is no clinical correlation with the periodontal health status of the patient postradiotherapy, and there is no mention of oral hygiene practices. Postradiotherapy oral mucositis can be a hindrance in the maintenance of regular oral hygiene,
        • Sciubba J.J.
        • Goldenberg D.
        Oral complications of radiotherapy.
        which can lead to poor periodontal health and subsequent bone changes.
      • 3.
        We are curious about the quality of the stored panoramic images, especially of the 204 film-based images, as there is no mention of any images excluded due to poor image quality.
      We take this opportunity to record our appreciation of the efforts put forth by the authors in conducting this study, which will definitely facilitate further research in this field.

      References

        • Chan K.C.
        • Perschbacher S.E.
        • Lam E.W.N.
        • et al.
        Mandibular changes on panoramic imaging after head and neck radiotherapy.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2016; 121: 666-672
        • Sciubba J.J.
        • Goldenberg D.
        Oral complications of radiotherapy.
        Lancet Oncol. 2006; 7: 175-183

      Linked Article

      • Mandibular changes on panoramic imaging after head and neck radiotherapy
        Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyVol. 121Issue 6
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          Changes to the radiographic appearance of the jaws after head and neck radiotherapy have not been thoroughly characterized. This retrospective study examines changes to the appearance of the mandible on panoramic images following intensity-modulated radiotherapy (IMRT) and relates these changes to medical co-morbidities and radiation dose.
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