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trattare i pazienti che si sottopongono a radioterapia. I consigli degli esperti","trattare-pazienti-sottopongono-radioterapia-consigli-esperti","La radioterapia nelle neoplasie della testa e del collo è una possibilità di trattamento. Un Lavoro pubblicato su Il Dentista Moderno ( 2010;05:110-122 ) analizza le possibili complicanze che…","\u003Cp>La radioterapia nelle neoplasie della testa e del collo è una possibilità di trattamento. Un Lavoro pubblicato su Il Dentista Moderno (\u003Ca href=\"http:\u002F\u002Fwww.rivistedigitali.com\u002FDentista_moderno\u002F2010\u002F5?targetPagNum=110&searchTerms=&tt=S\">2010;05:110-122\u003C\u002Fa>) analizza le possibili complicanze che insorgono a livello del cavo orale identificando una metodologia e dei criteri diagnostico-terapeutici che aiutino l’odontoiatra nella preparazione del paziente che si deve sottoporre a un trattamento radiante. Gli Autori hanno rilevato come solo l’11,2% dei pazienti che devono essere sottoposti al trattamento non necessitano di cure odontoiatriche. L’efficacia dello screening dentale pre-radioterapia è ben documentato. \u003C\u002Fp>\u003Cp>Il compito dello stomatologo, spiegano gli Autori, si è nel tempo modificato se infatti qualche anno fa la sua attenzione era rivolta unicamente all’eliminazione dei foci odontogeni, che con la loro presenza potevano interferire con il decorso postoperatorio, oggi l’obbiettivo è posto anche alla conservazione degli elementi dentari che risulteranno poi determinanti per una corretta riabilitazione protesica. L’eliminazione delle cause e la gestione delle complicanze durante e dopo il trattamento sono oggetto di valutazione e discussione. Particolare attenzione viene posta alla gestione della xerostomia e alle indicazioni per le terapie odontoiatriche. Anche se la gestione delle complicanze più gravi impone l’utilizzo di strutture protette, la prevenzione e il controllo trova nel dentista di fiducia un valido alleato spesso insostituibile.\u003C\u002Fp>\u003Cp>Queste le fasi e la tempistica del trattamento indicate dagli Autori.\u003C\u002Fp>\u003Cp>\u003Cstrong>Valutazioni pre-implantari\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>\u003Cu>Consultazioni\u003C\u002Fu>: Colloquio multidisciplinare. Individuazione del campo di irradiazione, della dose e dei limiti della dissezione chirurgica. Considerazioni sulla riabilitazione protesica post-trattamento.\u003C\u002Fp>\u003Cp>\u003Cu>Visita odontoiatrica\u003C\u002Fu>: Valutazione dei tessuti duri e molli. Valutazione dell’igiene orale e motivazione. Ortopantomografia. Misurazione dell’apertura della bocca. Sondaggio parodontale. Stesura del piano di cura.\u003C\u002Fp>\u003Cp>\u003Cstrong>Trattamento pre-operatorio\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>\u003Cu>Eliminazione dei focolai\u003C\u002Fu>: Trattamenti conservativi, parodontali e chirurgici. \u003C\u002Fp>\u003Cp>\u003Cu>Igiene e controlli\u003C\u002Fu>: Motivazione all’igiene orale e identificazione dei protocolli preventivi. Raccomandazioni dietetiche. Controllo dei siti post-estrattivi.\u003C\u002Fp>\u003Cp>\u003Cstrong>Durante il trattamento\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>Controllo dell’insorgenza di mucositi e infezione fungine, batteriche e virali. Prevenzione delle complicanze tardive.\u003C\u002Fp>\u003Cp>\u003Cstrong>Trattamento post-operatorio\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>\u003Cu>Prevenzione\u003C\u002Fu>: Prevenzione delle carie attraverso una dieta corretta, un’adeguata igiene orale, la stimolazione salivare e l’uso di clorexidina e\u002Fo fluoro. Prevenzione dell’ORN evitando estrazioni nel campo di irradiazione. In caso di necessità, valutare l’utilizzo dell’ossigenoterapia.\u003C\u002Fp>\u003Cp>\u003Cu>Riabilitazione\u003C\u002Fu>: Trattamento protesico definitivo.\u003C\u002Fp>\u003Cp>\u003Cu>Gestione\u003C\u002Fu>: Trattamento delle carie. 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