Pathways to Dental Rehabilitation After Head and Neck Cancer Treatment

This critical review paper discusses the prosthetic rehabilitation of patients with Head and Neck Cancer (HNC), with the prosthetic indication of Removable Complete Denture (RCD), Removable Partial Denture (RPD) and Fixed Partial Denture (FPD) and propose a guideline. A simple literature review was carried out and, based on this critical review beyond our clinical experience, a guideline was created to stimulate critical thinking when rehabilitating this patient profile. The dentist should minimize the discomfort and provide quality of life to these patients. However, often, the professionals feel unable, because the post-chemoradiotherapy biological behavior is altered by side effects as mucositis, xerostomia, and osteoradionecrosis. Critical issues as the prosthesis type to be planned, moment of treatment, type of irradiation, and primary or secondary area of irradiation are discussed based on the literature and the experience, to provide guidelines to rehabilitate patients with HNC. Considering the risks, the dentists should be part of a multidisciplinary team and use all information of this guideline. The treatment goal should be to improve the patient’s quality of life by evaluating the need of the rehabilitative dental treatment and the best moment for executing it.