Clinical outcomes of teeth adjacent to the site of mandibulotomy or mandibulectomy in patients with head and neck cancer - results from a multidisciplinary mono-institutional head and neck tumor board

Sep 24, 2026

Clinical outcomes were assessed for teeth adjacent to mandibulotomy or mandibulectomy sites in patients with head and neck cancers. Fourteen individuals undergoing segmental mandibulectomy or paramedian mandibulotomy, with a total of 23 adjacent teeth, were included; twelve received adjuvant head and neck radiotherapy. Cold sensitivity and/or electric pulp testing evaluated tooth vitality margins and adjacency after surgery. Tooth necrosis was common, supporting preoperative root canal therapy to reduce complications.

LanguageEnglish

CategoryHealthcare

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Pages7

Reading Time18 min

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Introduction

Surgical resections in mandibular cancer

Mandibulotomy access and reported postoperative complications

Castagnola etal. BMCOral Health (2023) 23:357 BMC Oral Health [https://doi.org/10.1186/s12903-023-03050-7](https://doi.org/10.1186/s12903-023-03050-7) RESEARCH Open Access Clinical outcomes of teeth adjacent to the site of mandibulotomy or mandibulectomyin patients with head and neck cancer: results from a multidisciplinary mono-institutional head and neck tumor board Raffaella Castagnola1†, Cosimo Rupe1*†, Gioele Gioco1, Giovanni Almadori2, Jacopo Galli2, Luca Tagliaferri3, Alessandra Cassano4, Patrizia Gallenzi1 and Carlo Lajolo1 Abstract Introduction The aim of this case series was to evaluate the necrosis of teeth adjacent to the site of mandibulotomy or mandibulectomy in a cohort of patients suffering from head and neck cancers. Methods Fourteen patients who underwent segmental mandibulectomy or paramedian mandibulotomy for oral, oropharynx or major salivary gland cancer and a total of 23 teeth were included in this case series. Twelve patients underwent adjuvant head and neck radiotherapy. Cold sensitivity pulp testing and/or electric pulp testing were performed on teeth at the margin of mandibulectomy and on teeth adjacent to mandibulotomy after surgery. A“positive” response was considered the healthy state, and “negative” was considered the diseased state of the tooth. Results The 10 patients who underwent mandibulotomy had 12 teeth with a negative response. The 4 patients treated by mandibulectomy had two positive and three negative responses to cold and electric pulp tests. Fifteen out of 23 teeth (65 . 2%) showed a negative response to sensitivity testing. Conclusions Tooth necrosis seems to be a common event after mandibulectomy and mandibulotomy. Clinical Relevance To avoid post-surgery complications, performing root canal therapy before surgery on the teeth adjacent to the surgical site could be an appropriate strategy. Keywords Head and Neck Cancer, Oral Cancer, Mandibulotomy, Mandibulectomy, Tooth prognosis, Tooth survival †Raffaella Castagnola and Cosimo Rupe contributed equally to this work. *Correspondence: Cosimo Rupe [cosimorupe@gmail.com](cosimorupe@gmail.com) 1Head and Neck Department, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Rome 00168, Italy 2Head and Neck Department, Institute of Otolaryngology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Rome 00168, Italy 3Department of Radiation Oncology, Institute of Radiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Rome 00168, Italy 4Department of Medical Oncology, Institute of Radiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, Rome 00168, Italy © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The)[. The](http://creativecommons.org/licenses/by/4.0/. The)[ ](http://creativecommons.org/licenses/by/4.0/. The)Creative Commons Public Domain Dedication waiver ([http://creative

FAQs

What was the aim of this case series?

To evaluate necrosis of teeth adjacent to the surgical sites of mandibulotomy or mandibulectomy in patients with head and neck cancers.

How were the teeth evaluated after surgery?

Cold sensitivity pulp testing and/or electric pulp testing were performed on teeth at the margin of mandibulectomy and on teeth adjacent to mandibulotomy.

What conclusion does the study reach about tooth necrosis?

Tooth necrosis appears to be a common event after both mandibulotomy and mandibulectomy.

Sep 24, 2026

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