DENTAL REHABILITATION NEEDS IN PATIENTS WITH A HISTORY OF CANCER: PERIODONTAL STATUS AND ITS ROLE IN FUNCTIONAL RECOVERY
DOI:
https://doi.org/10.32782/2522-1795.2026.20.1.8Keywords:
history of cancer; radiotherapy; periodontium; periodontal indices; treatment needs; dental rehabilitation; implantation; quality of lifeAbstract
Improved survival following contemporary cancer therapies has led to an increasing need for long-term medical and dental rehabilitation. Periodontal involvement in patients with a history of cancer may follow a more aggressive course and limit the potential for functional restoration of the dentoalveolar system.
Aim. To assess periodontal status and the need for periodontal treatment in patients with a history of cancer (considering exposure to radiotherapy) in order to substantiate approaches to dental rehabilitation.
Materials and methods. A clinical screening examination included 200 individuals aged ≥30 years: 110 patients with a history of cancer (Group 1 – 60 after radiotherapy; Group 2 – 50 without radiotherapy) and 90 controls without oncological history. Only patients with clinically confirmed periodontal pathology were included in the final analysis. Periodontal status was assessed using the Periodontal Screening and Recording (PSR) index to determine treatment needs, the Plaque Index (PI) to evaluate oral hygiene, and the PMA index to quantify gingival inflammation.
Results. Statistically significant differences between groups were observed for all indices (p<0.05). The most pronounced pathological changes occurred in patients who had undergone radiotherapy. PSR values were 3.22±0.41 in Group 1, 2.84±0.52 in Group 2, and 2.13±0.42 in controls, indicating a substantially greater need for comprehensive periodontal treatment in oncological patients, particularly after radiotherapy. The Plaque Index showed a similar pattern: 2.16±0.32 in Group 1, 1.82±0.34 in Group 2, and 1.24±0.25 in controls, reflecting markedly poorer oral hygiene in patients with a cancer history. PMA values reached 46.55±6.81% in Group 1, 38.42±5.91% in Group 2, and 24.14±4.61% in controls (p<0.05), demonstrating increased inflammatory activity of periodontal tissues, especially after radiotherapy, and indicating a higher risk of progressive periodontal destruction. Overall, these findings suggest a considerable reduction in the periodontal rehabilitation potential in patients with a history of cancer, particularly those exposed to radiotherapy.
Conclusions. A history of cancer, and especially radiotherapy, is associated with impaired periodontal status, increased treatment needs, and poorer oral hygiene. The use of standardized indices (PSR, PI, PMA) is appropriate for risk stratification and for planning dental rehabilitation, including prosthetic treatment and implant therapy, in this patient population.
References
1. Abou-Bakr, A., Ahmed, E., William, H., & Hassanein, F. E. A. (2025). Frequency of periodontal disease in head and neck cancer patients after radiation therapy: a cross-sectional study. BMC Oral Health, 25(1), 1008. https://doi.org/10.1186/s12903-025-06391-7
2. Abou-Bakr, A., Hassanein, F. E. A., William, H., & Ibrahim, S. S. (2025). Prevalence of late xerostomia and hyposalivation with associated risk factors in survivors of head and neck cancer after radiotherapy: a multi-centric cross-sectional study. Radiation Oncology, 20(1), 162. https://doi.org/10.1186/s13014-025-02737-1
3. Altman, D. G., & Bland, J. M. (1996). Comparing several groups using analysis of variance. BMJ, 312(7044), 1472-1473. https://doi.org/10.1136/bmj.312.7044.1472
4. Antic, S., Markovic-Vasiljkovic, B., Dzeletovic, B., Jelovac, D. B., & Kuzmanovic-Pficer, J. (2022). Assesment of radiotherapy effects on the blood flow in gingiva and dental pulp – a laser Doppler flowmetry study. Journal of Applied Oral Science, 30, e20220329. https://doi.org/10.1590/1678-7757-2022-0329
5. Brandt, E., Keskin, M., Räisänen, I. T., Mäkitie, A., Pätilä, T., Sorsa, T., & Gupta, S. (2024). Periodontal Disease - A Late Complication of Head and Neck Cancer Radiotherapy. Cancer Control, 31, 10732748241255845. https://doi.org/10.1177/10732748241255845
6. Bruno, J. S., Heidrich, V., Restini, F. C. F., Alves, T. M. M. T., Miranda-Silva, W., Knebel, F. H., et al. (2025). Dental biofilm serves as an ecological reservoir of acidogenic pathobionts in head and neck cancer patients with radiotherapy-related caries. mSphere, 10(7), e0025725. https://doi.org/10.1128/msphere.00257-25
7. Grygus, I., Kostyshyn, A., Ilnytska, O., Ornat, H. (2022). The condition of the masticatory muscle group in the treatment of patients with reduced occlusion height. Health Prob Civil. 16(2):164-172. https://doi.org/10.5114/hpc.2022.117884
8. Idris, M. Z., Wimardhani, Y. S., Apsari, W., & Mandasari, M. (2026). Head and Neck Radiotherapy Short-Term Oral Complications: Effect on Oral Health-Related Quality of Life at Dharmais Cancer Hospital. European Journal of Dentistry. https://doi.org/10.1055/s-0046-1816079
9. Kinash, I., Kaminska, M., Stasiuk, M., Grygus, I., Zukow, W. (2021). Bacteriological study of oral microbiocenosis as a starting point for begin pharmaceutical treatment. Pharmacologyonline. vol. 2. 7-16.
10. Mauceri, R., Coppini, M. C., Marchese, S. M., Mauceri, N., Coniglio, R., Nisi, M., et al. (2025). Oral health status and quality of life in female patients receiving low dose bone-modifying agents for cancer treatment-induced bone loss: a single-center exploratory study. Frontiers in Oral Health, 6, 1683722. https://doi.org/10.3389/froh.2025.1683722
11. Piyarathne, N., Sinclair, S., Elsayed, K. S., Cook, C., Gupta, E., & Abu-Eid, R. (2025). Oral health-related quality of life in head and neck cancer: a systematic review. Frontiers in Oral Health, 6, 1691065. https://doi.org/10.3389/froh.2025.1691065
12. Qamar, S., Rozi, S., Sawani, S., Awan, M. S., Akhtar, S., Siddiqui, M. I., et al. (2024). Oral health related quality of life in head and neck cancer survivors within the first year following treatment: a cross-sectional study in Karachi, Pakistan. Scientific Reports, 14(1), 2560. https://doi.org/10.1038/s41598-024-52813-x
13. Shamekhi, S., King, S., Chugh, H., Rudman, A., Pradhan, A., Yeoh, S. C., & Christian, B. (2026). Strategies to manage the oral health impacts of head and neck cancer treatment: A scoping review. Journal of Dentistry, 164, 106249. https://doi.org/10.1016/j.jdent.2025.106249
14. Staruch, M., Speth, M. M., Neyer, P., Riesterer, O., Aebersold, D. M., & Stieb, S. (2024). Radiation-associated changes in saliva composition of head and neck cancer patients: A systematic review. Radiotherapy and Oncology, 196, 110279. https://doi.org/10.1016/j.radonc.2024.110279
