Perfil de pacientes sob tratamento oncológico que realizaram radiografia panorâmica em uma clínica de Salvador – Bahia durante o período de 2016 a 2020

Abstract

Introduction: Previous dental disorders and inadequate oral hygiene are risk factors for emergence of oral complications during oncotherapy. It is important for dentist and the medical team working together to carry out prevention and dental therapies before and during oncotherapy. Objective: Evaluation of epidemiologic and imaging profile of individuals in cancer treatment who underwent panoramic radiograph before or during cancer therapy in a referenced diagnostic imaging clinic in Salvador-Bahia between August 2016 and March 2020. Material and methods: Sixty-five panoramic radiographs of these individuals were evaluated, which were divided into oncological pre-treatment and during treatment. The tabulation of data showed: date of examination, gender, age, tumor location, presence and location of metastasis, stage and oncotherapeutic treatment, number of teeth with caries lesions, residual roots, signs that were affected by strict bone loss, except for furcation and with furcation involvement, root lesion, presence of dental calculus, overall bone loss, cortical mandibular canal and mandibular cortical index. Variables that were analyzed are related to necessity of endodontic treatment, as well as periodontal treatment, extraction and restoration, and number of teeth with such needs. Results: 65 people were part of the analysis, 47.7% were in pre-treatment and 52.3% during treatment. In pre-treatment, 51.6% were male and 48.4% female, while 23.5% and 73.5%, respectively, during treatment. The age group in pre-treatment was 19.4% less than 45 years old and 80.6% 45 years old or more while during treatment it was 8.8% and 91.2%, respectively. Regarding antiresorptive and antiangiogenic medication, they were used only during treatment, which correspond to 41.2%. In terms of treatment modality, either made combined or separately during pre-treatment 25.8% were submitted to surgery, 35.5% to radiotherapy, 80.6% to chemotherapy, 22.6% to hormone therapy, 6.5% to target therapy, 29% to immunotherapy, 6.5% to bonn marrow transplant, 0% to iodine therapy, 3.2% to comfort measures and home palliative care; during treatment numbers showed 47.1%, 35.3%, 91.2%, 38.2%, 20.6%, 2.9%, 2.9% 0% and 0%, respectively. Patients that presented dental calculus in pre-treatment corresponded to 67.7% and 85.3% during treatment. Necessity of endodontic treatment corresponded to 3% in pre-treatment and 85.3% during treatment. In terms of number of teeth with necessity of endodontic treatment, median value corresponded to 4 (q=1 and q3=6) in pre-treatment and 4 (q1=2 and q3=7) during treatment. Regarding generalized bone loss, in pre-treatment, 45.2% of patients showed no signs of generalized bone loss, 22.6% mildly, 9.7% mild to moderate, 12.9% moderate, 3.2% moderate to severe and 6. 5% severe; during treatment these values were 32.4%, 29.4%, 8.8%, 23.5%, 2.9% and 2.9%. In terms of cortical mandibular canal, in pre-treatment, numbers showed 22.6% of continuous cortical mandibular canal, 51.6% discontinuous and 25.8% indefinite; during treatment, numbers showed 17.6%, 67.4% and 17.6%, respectively. Numbers of mandibular cortical index, in pre-treatment, showed 6.5% in C1, 35.3% in C2 and 55.9% in C3; and 8.8%, 35.3% and 55.9% respectively, during treatment. Conclusion: There were a large number of patients with unsatisfactory oral hygiene and some with necessity of endodontic treatment. This number was high in pre-treatment, but it was even higher in patients who were on anticancer therapy. Low bone mineral density was lower during oncotherapy.