Development of tools for the oral health and panoramic radiograph evaluation of head and neck cancer patients: a methodological study.

PURPOSE: Describe the methodology used to construct tools for standardized data collection of head and neck cancer patients (HNCP). METHODS: We constructed the Oral Health Evaluation Tool (OHET) and Panoramic Radiograph Evaluation Tool (PRET) for systematic collection of long-term oral clinical/radiographical complications, prevalence, and severity. Tools were pilot-tested in 50 chemoradiation-treated HNCP >6 months post-therapy. RESULTS: Tools allowed for collection of extensive clinical and radiographical data. A medium of 1.9 years had elapsed since chemoradiation completion. Patients had a median of 6 missing teeth, 32.7% had no decay and a medium of 30% had filled surfaces; 42.9% had moderate-to-severe decay. Reduced/thickened saliva was noted in 85.4% and dry mucosa in 93.9%. Gingival bleeding was present in 75.5% HNCP and attachment loss in 86%. Four patients had trismus. CONCLUSIONS: Tools were user friendly and provided comprehensive, reproducible, and inexpensive means to evaluate post-therapy oral health of HNCP. Validation testing is ongoing.

Accuracy of cone beam computed tomography in determining the location of the genial tubercle.

OBJECTIVE: To determine the accuracy of cone beam computed tomography (CT) to predict the location of the genial tubercle. STUDY DESIGN AND SETTING: Cadaver study for anatomic analysis of 17 adult human cadaver heads. Each skull/cadaver head underwent radiographic imaging with cone beam CT and cadaver dissection. Measurements, including mandibular height (MH), genial tubercle width (GTW), genial tubercle height (GTH), distance from inferior border of mandible to genial tubercle (IBM/GT), and mandibular thickness (MT) were recorded. RESULTS: Statistical analysis with paired t test showed no significant difference between cadaver dissections versus cone beam measurements. Ninety-five percent confidence intervals (CI) were as follows: GTW (-0.2 to 1.0), GTH (-0.1 to 0.9), distance IBM/GT (-0.8 to 5.0), MH (-1.3 to -2.6), and MT (-0.1 to 0.3). CONCLUSION: These results show the accuracy of the 3D cone beam CT in the anatomic location of the genial tubercle. SIGNIFICANCE: This radiographic technique may prove useful in pre-operative planning for the mandibular osteotomy in genioglossus advancement procedures.