Assessment of radiation damaged bone
Research type
Research Study
Full title
Evaluation of radiation-induced jaw tissue damage to predict success of dental implant rehabilitation
IRAS ID
194559
Contact name
Lucy Di Silvio
Contact email
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Some patients with head and neck cancer (HNC) are treated by radiotherapy (RT). One of the main side-effects of this treatment is death of non-cancerous jaw bone (osteoradionecrosis, ORN). ORN leads to swelling and infection which can spread through the jaw leading to eventual fracture. It has a significant bearing on quality of life and patients can quickly deteriorate from this complication having been cured of their cancer. In order to avoid ORN, removal of numerous healthy teeth is often carried out prior to these patients receiving radiotherapy. Furthermore, other side-effects of RT include dry mouth (leading to decay and gum disease) and reduction in mouth opening. These combination of effects exacerbate tooth loss and ORN in these patients.
Dental implants have the ability to rehabilitate the mouth in post-RT patients. However, success of dental implants placement is lower in post-RT patients compared non-RT groups. Due to decreased bone viability in the former, dental implant failure (infection, loss of implant) may also induce ORN. The fear of patients having ORN is leaving many patients without dental rehabilitation and treatment.
To our knowledge, there has been no work done to develop criteria to predict which post-RT patients are likely to develop ORN. We propose to evaluate in detail the degree of tissue changes in bone of patients scheduled for dental implant treatment who have had RT. The small fragments of bone routinely removed as part of the implant placement procedure, normally otherwise discarded, will be assessed for several tissue and molecular markers of viability. Similar archival tissue, surplus to diagnostic and therapeutic requirements will similarly be evaluated. Quantification of these markers will then be retrospectively and prospectively correlated with defined criteria of dental implant success. It is anticipated that our research will enable ORN risk stratification in this vulnerable group of patients.
REC name
London - Dulwich Research Ethics Committee
REC reference
16/LO/1797
Date of REC Opinion
18 Nov 2016
REC opinion
Further Information Favourable Opinion