The impact of head and neck radiotherapy on the dentine- enamel junction: a systematic review

Author(s):Show less -

Fonseca, Jessica Montenegro ^[1] ; Madrid Troconis, Cristhian Camilo ^[2] ; Palmier, Natalia Rangel ^{[1, 3]} ; Gomes-Silva, Wagner ^[4] ; Paglioni, Mariana de Pauli ^{[1, 3]} ; Damaceno Araujo, Anna Luiza ^{[1, 3]} ; Aristizabal Arbo-leda, Lady Paola ^{[1, 3]} ; Vechiato Filho, Aljomar Jose ^[4] ; Gonzalez-Arriagada, Wilfredo Alejandro ^[5] ; de Goes, Mario Fernando ^[2] ; Lopes, Marcio Ajudarte ^{[1, 3]} ; Brandao, Thais Bianca ^{[4, 6]} ; Vargas, Pablo Agustin ^{[1, 3]} ; Prado Ribeiro, Ana Carolina ^{[1, 3, 4]} ; Santos-Silva, Alan Roger ^{[1, 3]}

Affiliation

^[1] Univ Estadual Campinas, UNICAMP, Piracicaba Dent Sch, Oral Diag Dept, Semiol & Oral Pathol Areas, Piracicaba, SP - Brazil

^[2] Univ Estadual Campinas, UNICAMP, Piracicaba Dent Sch, Dept Restorat Dent, Piracicaba, SP - Brazil

^[3] Brandao, Thais Bianca, Odontol Oncol Dor, Sao Paulo, Brazil.Fonseca, Jessica Montenegro, Univ Estadual Campinas, UNICAMP, Piracicaba Dent Sch, Oral Diag Dept, Semiol & Oral Pathol Areas, Piracicaba, SP - Brazil

^[4] Univ Sao Paulo, Fac Med, Inst Canc Estado Sao Paulo ICESP, Dent Oncol Serv, Sao Paulo - Brazil

^[5] Univ Valparaiso, Fac Odontol, Valparaiso - Chile

^[6] Odontol Oncol Dor, Sao Paulo - Brazil

• Document type: Review article
• Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL; v. 25, n. 1, p. E96-E105, JAN 2020.
• Web of Science Citations: 1

Abstract

Background: Radiotherapy is widely used in contemporary head and neck cancer treatment protocols. The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic destruction to the teeth is one of the most controversial topics in the field of oral oncology. Therefore, this systematic review aimed to investigate ionising radiation as an independent factor for physical and chemical changes on the dentine-enamel junction (DEJ), a pivotal dental topography for the onset and progression of radiation-related caries (RRC) and enamel delamination. Material and Methods: Systematic searches were conducted on three databases: Scopus, MEDLINE (Via PubMed) and Embase (Elsevier). Laboratory studies evaluating the effects of simulated or in vivo HNRT on the DEJ were included. The GRADE tool adapted for in vitro studies was used to assess the methodological quality. Results: Of the 154 initially selected studies, eight met the inclusion criteria, from which five studies were graded as high quality of evidence, two studies were graded as moderate quality and one as low quality. Two studies did not demonstrate DEJ alterations following HNRT while the other six articles described several organic and inorganic changes in the DEJ of irradiated teeth samples. These radiogenic events were mostly detected through micro and nanoindentation, Raman micro-spectroscopy, confocal microscopy, Western blotting and optical coherence tomography. Conclusions: HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination. (AU)

• FAPESP's process: 12/06138-1 - A prospective study of radiation-induced trismus in patients with oral squamous cell carcinoma
• Grantee: Ana Carolina Prado Ribeiro e Silva
• Support type: Regular Research Grants
• FAPESP's process: 13/18402-8 - Evaluation of the direct effects of radiation on the enamel, dentin and dental pulp of head and neck cancer patients
• Grantee: Alan Roger dos Santos Silva
• Support type: Regular Research Grants