24 Chapter 1 QoL of edentulous maxillectomy patients after prosthetic obturation (4a), and compared the objective and subjective masticatory function of patients with implant-supported obturators with patients with surgically reconstructed maxillae (4b). Removal of teeth with limited prognosis, identified as a potential cause of oral cavity infection prior to head and neck RT, is associated with a lower risk of developing osteoradionecrosis (ORN). At the same time, tooth extractions result in a reduced number of functional units and impair both chewing and swallowing. To ensure that extraction wounds have adequate time to heal (at least 10 to 14 days) before starting RT, the decision of whether extraction is warranted is made based on the expected radiation dose. However, for some of the extracted teeth, it may be found after completion of RT that the extraction was not indicated due to the RT dose received being lower than expected. In Chapter 5 we examined the number and patient and tumor characteristics associated with this number of redundantly extracted teeth. After HNC treatment, sufficient time must be allowed for adequate wound healing before successful prosthetic rehabilitation can begin. This means that patients who have to undergo RT have a deteriorated masticatory system during this RT. This impairment in mastication has been associated with oropharyngeal dysphagia, and oropharyngeal dysphagia is significantly related to involuntary weight loss. In Chapter 6, we examined the effects of incomplete dentition and tooth extractions on weight loss during RT combined with chemotherapy (CRT) or biotherapy (BRT) and the need for tube feeding during CRT or BRT for patients with oropharyngeal carcinoma.
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