Multidisciplinary oral rehabilitation after head and neck radiotherapy

BACKGROUND: Radiotherapy for head and neck cancer is associated with adverse oral effects, including salivary gland hypofunction, radiation-related caries, and periodontal tissue alterations, which negatively impact oral health and quality of life. METHODS: A 56-year-old male previously treated with surgery, radiotherapy, and chemotherapy for oropharyngeal cancer presented with dentin hypersensitivity, gingival recession, and reduced keratinized tissue. A multidisciplinary rehabilitation was performed, including non-surgical periodontal therapy, free gingival grafting, restorative treatment of cervical lesions, prosthetic rehabilitation, and individualized preventive maintenance. RESULTS: Uneventful healing was observed at all surgical sites. The free gingival grafts resulted in increased keratinized tissue and vestibular depth, with stable periodontal conditions and resolution of dentin hypersensitivity. Clinical stability was maintained throughout a 24-month follow-up period, with no adverse radiation-related effects. CONCLUSIONS: Multidisciplinary oral rehabilitation, including mucogingival surgery and preventive care, can be safely and effectively performed in irradiated patients, improving periodontal stability, oral comfort, and quality of life. KEY POINTS: Head and neck radiotherapy can cause long-lasting oral complications that require careful and individualized dental management. Periodontal surgery, restorative treatment, and prosthetic rehabilitation can be safely performed in irradiated patients when properly planned and followed. Long-term preventive maintenance is essential to maintain oral health and minimize complications in head and neck cancer survivors.