Case Report Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma Atacan Yavuz, 1 Ömer Birkan ALralJ, 1 Zeynep Lale ÇalJGkan, 2 Dilek TürkaydJn, 3 Atilla Sertgöz, 2 Bahar Kuru, 1 and BaGak DoLan 1 1 Department of Periodontology, Faculty of Dentistry, Marmara University, Nis ¸antas ¸ı Kampusu, B¨ uy¨ ukc ¸itlik Sok. No. 8, Nis ¸antas ¸ı-S ¸is ¸li, 34365 Istanbul, Turkey 2 Department of Prosthodontics, Faculty of Dentistry, Marmara University, Nis ¸antas ¸ı Kampusu, B¨ uy¨ ukc ¸itlik Sok. No. 8, Nis ¸antas ¸ı-S ¸is ¸li, 34365 Istanbul, Turkey 3 Department of Endodontics, Faculty of Dentistry, Marmara University, Nis ¸antas ¸ı Kampusu, B¨ uy¨ ukc ¸itlik Sok. No. 8, Nis ¸antas ¸ı-S ¸is ¸li, 34365 Istanbul, Turkey Correspondence should be addressed to Bas ¸ak Do˘ gan; basakdogan@marmara.edu.tr Received 25 October 2013; Accepted 18 December 2013; Published 9 January 2014 Academic Editors: A. Y. Gamal, J. L´ opez-L´ opez, and M. W. Roberts Copyright © 2014 Atacan Yavuz et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Radiotherapy in NPC patients has side efects on the dentition, which afects quality of life dramatically. his case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. he adolescent patient applied to dental hospital 4 years ater the radiotherapy with aesthetic and functional problems on dentition afecting psychological, social, and physical aspects of his life. he dentition of the patient demonstrated the severe destruction as a devastating side efect of radiotherapy. With a successful multidisciplinary approach, our patient’s aesthetics, function, and self-conidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy. 1. Introduction Nasopharyngeal carcinoma (NPC) is a malign neoplasm occurring in the epithelial layer of the nasopharynx. he irst symptom of the disease in the 60% of the patients is enlarged cervical lymph nodes which represents metastasis. Obstruction of the eustachian tube occurs in nearly 50% of patients, which leads to unilateral serous otitis media and hearing loss. Less frequent symptoms may be like the symptoms of temporomandibular dysfunction, which is more common for the dentist, thus complicating the problem [1]. Nasopharyngoscopy, computerized tomography and/or magnetic resonance imaging on suspicious lesions, and histo- logical examination by biopsy are required for diagnosis [2]. All the major and minor salivary glands of the NPC patients who were treated with radiotherapy are afected by the large irradiation doses, thus leading the patients into severe and persistent xerostomia [3]. Occasionally, the most anterior portion of the loor of the mouth may stand unaf- fected [2]. Recovery of salivary output of patients is not signiicant [3]. Radiotherapy may lead to dental caries, even in the patients who had not experienced caries in lifetime [4]. he decrease of saliva secretion and alternation of its quality are the key factors of the radiation caries. Also dental tissues are afected by radiation directly, making teeth more susceptible to decalciication [4]. Other complications are oral candidiasis consequent to shit in the oral microlora, transient taste alterations, malnutrition and weight loss, and restricted movement of mandible as a sequel of ibrosis on mastication muscles [3, 5]. Osteoradionecrosis is the most devastating consequence of the radiotherapy. Irradiation damages osteocytes and microvascular structures; blood vessels thicken and marrow Hindawi Publishing Corporation Case Reports in Dentistry Volume 2014, Article ID 918461, 5 pages http://dx.doi.org/10.1155/2014/918461