Search

About 10% of patients developed severe sequelae following radiotherapy, which had been associated with surgical treatment, even though they were, or appeared to be cured. Complications affected the skin and soft tissues (causing skin retraction, loss of substance, and sometimes trismus) and bone (necrosis required surgical treatment, and when there was associated cutaneous dystrophy, resulted in exposure of the bone and severe functional and esthetic problems). A critical study of the radiotherapeutic techniques used suggests that the dose given should be reduced, the fields modified, and Cobalt used in preference to electrons in most cases.

The treatment of a certain number of children with very severe dentomaxillary sequelae after radiotherapy for facial and intracranial lesions raises many problems. These include the type of reconstructive therapy, the protection of the maxillodental structures, the value of local and alimentary hygiene, and the quantity and quality of dental treatment needed. Further difficulties are encountered because of dental malformations (absence of roots), increased rate of eruption of the teeth in the arch (contrary to the accepted opinions), and objectives should be modest when attempting maxillofacial orthopedic procedures.