29 Mandibular Dentures in Head and Neck Cancer Patients 2 Introduction Treatment of head and neck cancer has an enormous impact on patients’ lives. Therapy-related functional and esthetic problems directly influence the outer appearance, social interaction and oral functions, such as mastication, swallowing, speech and nutrition of patients [1-3]. Current advances in microsurgery in combination with dental implants have led to better functional and esthetic outcomes [4]. However, radiation therapy and chemotherapy still cause unfavorable side effects such as reduced swallowing ability, xerostomia, and a painful and tender mucosa [2, 3, 5]. These side effects have an impact on the quality of life (QoL) and may last forever [3, 6-8]. In the rehabilitation process, after tumor treatment, prosthetic rehabilitation plays a prominent role in improving oral functions and QoL [7, 9]. Implantretained dentures (IODs) are a standard treatment in head and neck cancer patients. Several studies in irradiated and nonirradiated patients presented high implant survival rates varying from 69% to nearly 99% [4, 10, 11]. However, the percentage of head and neck oncology patients, who are rehabilitated with the use of implants widely varies from 22% to 91% [7]. There are different reasons for this variation. Among others, survival rate, length of follow-up, and financial aspects play important roles depending on local insurance regulations. A positive correlation can be found between denture satisfaction and overall QoL in head and neck cancer patients [12]. There is some evidence regarding better outcomes for IODs in edentulous individuals compared with conventional dentures (CDs) [13, 14]. For irradiated edentulous patients, the same assumptions have been made [10, 11, 15]. This might imply that IODs increase denture satisfaction and the overall QoL in head and neck cancer patients. Thus, prosthetic rehabilitation appears to aid in a successful overall treatment of head and neck cancer. The objectives of this retrospective study were threefold: to assess the overall percentage of functioning IODs and CDs and to determine patient satisfaction with dental rehabilitation with respect to QoL in both the IOD and CD groups. Data acquisition was based on patients treated for primary head and neck cancer at the Maastricht University Medical Center (MUMC) who had to undergo radiation therapy at the Maastro clinic between January 2006 and January 2011.
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