RESUMO
OBJECTIVES: To examine the relationship of reduced numbers of occluding teeth and dietary intake (DI), nutrition impact symptoms (NIS), and weight loss (WL) in head and neck cancer (HNC) patients. METHODS: As a part of the standard of care, treatment-naïve HNC patients (n = 104) completed dental evaluation (number of teeth, total anterior/posterior occlusal teeth, Eichner Index (EI) classification), WL, DI questionnaire and HNC Symptom Checklist©. Descriptive statistics (Kruskal-Wallis, Fisher-exact, χ2 tests) and (uni-) multi-variable logistic regression. RESULTS: Overall, 42, 45 and 13% of patients were in EI-class A, B and C with a median of 8, 3, and 0 total posterior occlusal teeth. EI-class B/C patients were older, more likely to have impaired DI (OR = 3.88; 95%CI:1.63-9.26; P = 0.002) and reported interference with DI by 11 NIS (p < 0.05). DI was, however, reported as unimpaired in 77, 49 and 39% of patients in EI-class A, B and C, respectively. The subset of EI-class B/C patients with impaired DI, had more NIS interference with DI (P < 0.05; difficulty chewing, pain, early satiety, lack of energy); EI-class C patients additionally had dry mouth, thick saliva and dysphagia (P < 0.05). In logistic regression, EI-classes B/C patients with reduced (vs unimpaired) DI were more likely to have ≥5% WL (OR = 10.1; 95%CI:2.0-50.0), higher NIS interference (range OR 4.3-10.7). CONCLUSIONS: More than half of these HNC patients had reduced numbers of occlusal teeth or were edentulous. EI-class B/C patients did not necessarily have impaired DI, however the combination of EI-class B/C and a constellation of NIS, associated with reduced DI. CLINICAL SIGNIFICANCE: Treatment naïve head and neck cancer (HNC) patients with reduced occlusal and masticatory performance (Eichner Index B/C) and reduced dietary intake are at high risk for weight loss. Identifying HNC patients at risk may improve their oral health, dietary intake and reduce their risk of weight loss.
RESUMO
OBJECTIVE: To evaluate the magnitude of lower incisor inclination associated with the vertical facial type in adolescent Class II patients treated with the Xbow appliance. MATERIALS AND METHODS: A total of 172 consecutive Class II patients treated with only the Xbow appliance were used. The sample was divided into three groups based on their vertical facial type (24 short, 122 normal, and 25 long facial types). The mean age was 11.11 years at T1 with a mean active Xbow time of 4.5 months. A mean of 6.4 months passed after the Xbow deactivation before T2 radiograph. RESULTS: No significant association between lower incisor proclination and vertical facial type was found. Actual differences between T1 and T2 did exist. In most cases, these differences may be considered clinically relevant, but when the large interindividual variability is considered, the differences between the groups could not be statistically supported. At T1, a distinct trend to have more proclined lower incisors in the short (100.5 degrees ) compared with the long (91.3 degrees ) facial types was found. During treatment, a trend was identified for more proclination of the lower incisor the shorter the face. CONCLUSIONS: Although lower incisors do procline with the use of the Xbow appliance, facial type does not appear to affect the amount of lower incisor inclination. The magnitude of the incisor proclination can be considered not clinically relevant, but a large individual variation in the incisor response was identified.