HPV-related oropharyngeal cancer: a review on burden of the disease and opportunities for prevention and early detection

The incidence of oropharyngeal cancer (OPC) related to infection with human papillomavirus (HPV) is rising, making it now the most common HPV-related malignancy in the United States. These tumors present differently than traditional mucosal head and neck cancers, and those affected often lack classic risk factors such as tobacco and alcohol use. Currently, there are no approved approaches for prevention and early detection of disease, thus leading many patients to present with advanced cancers requiring intense surgical or nonsurgical therapies resulting in significant side effects and cost to the health-care system. In this review, we outline the evolving epidemiology of HPV-related OPC. We also summarize the available evidence corresponding to HPV-related OPC prevention, including efficacy and safety of the HPV vaccine in preventing oral HPV infections. Finally, we describe emerging techniques for identifying and screening those who may be at high risk for developing these tumors

A pattern of care analysis: Prosthetic rehabilitation of head and neck cancer patients after radiotherapy

Background While some medical associations provide guidelines for the implant‐prosthetic rehabilitation of head and neck cancer patients, the circulation and implementation in the everyday routine of practicing dentists remain unknown. Purpose To analyze patterns of care for the prosthetic rehabilitation of head and neck cancer patients after radiotherapy in German speaking countries. Materials and methods An online survey consisting of 34 questions separated into three sections, (a) general inquiries, (b) treatment concepts, and (c) patient cases, was forwarded to university hospital departments for Prosthetic Dentistry and Oral and Maxillofacial Surgery, and members of different medical associations. Statistical differences between groups were analyzed using chi‐squared test (P < .05). Results From May to October 2019, 118 participants completed the survey. The majority practiced in university hospitals, had more than 5 years of work experience, and reported to be involved in <10 post radiation prosthetic rehabilitation cases per year. Rehabilitation protocols involving dental implants were implemented by oral/oral‐ and maxillofacial surgeons and prosthetic dentists, while general dentists favored implant‐free solutions. Xerostomia was recognized as a common problem for a successful prosthetic rehabilitation. The subsequent treatment choice with either fixed dental prostheses or removable dentures was divided among participants. Conclusions As treatment planning differed with regard to the participants' field of expertise and work environment, and most practitioners only handle a low number of cases, patients might benefit from centralization in larger institutes with a multidisciplinary structure. A high agreement between the practitioners' treatment concepts and the current state of research was observed. While the choice between a mucosa‐ or tooth‐supported, and an implant‐supported restoration depends on numerous individual factors, guidelines derived from longitudinal studies would enhance evidence‐based treatment in this field