Influence of periodontitis on the experience of oral mucositis in cancer patients undergoing head and neck radiotherapy: a pilot study

Abstract

Periodontitis and radiation-induced oral mucositis are both inflammatory conditions which may be associated through a common underlying dysregulation of the inflammatory response. This pilot study aimed to determine whether the severity of oral mucositis is associated with the severity of periodontitis in cancer patients undergoing head and neck radiotherapy. In this pilot study, 41 patients met the inclusion criteria. The severity of oral mucositis was measured according to the WHO system. The severity of periodontitis was assessed clinically and radiographically. Gingival crevicular fluid was sampled and levels of eight cytokines were determined using a multiplexed bead immunoassay. Associations between radiation-induced oral mucositis and periodontitis were analysed using logistic and linear regression. There was a trend towards a greater proportion of periodontitis patients in the mucositis groups (grades = 1-4) than in the non-mucositis group (grade = 0). However, due to the small sample size of this pilot study, these trends were not statistically significant. This pilot study did not demonstrate a positive statistical correlation between periodontitis experience and severity of radiation-induced oral mucositis. Nonetheless, a trend towards increased bone loss, pocket depth and clinical attachment levels was noted in patients with mucositis grades 1-4. Larger studies with more stringent inclusion criteria are now required to further investigate this possible relationship between periodontitis experience and severity of radiation-induced oral mucositis.