Radiation-related caries: current diagnostic, prognostic, and management paradigms

Autor(es)

Palmier, Natalia Rangel ^[1] ; Migliorati, Cesar Augusto ^[2] ; Prado-Ribeiro, Ana Carolina ^[3] ; Querido de Oliveira, Maria Cecilia ^[3] ; Vechiato Filho, Aljomar Jose ^[3] ; de Goes, Mario Fernando ^[4] ; Brandao, Thais Bianca ^[3] ; Lopes, Marcio Ajudarte ^[1] ; Santos-Silva, Alan Roger ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Piracicaba Dent Sch, Oral Diag, Piracicaba, SP - Brazil

^[2] Univ Florida, Coll Dent, Gainesville, FL - USA

^[3] ICESP FMUSP, Dent Oncol Serv, Sao Paulo State Canc Inst, Sao Paulo, SP - Brazil

^[4] Univ Estadual Campinas, Restorat Dent Dept, Piracicaba Dent Sch, Piracicaba, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY; v. 130, n. 1, p. 52-62, JUL 2020.
• Citações Web of Science: 0

Resumo

Objective and study design. This narrative review summarizes the current state of art of radiation-related caries (RC), an aggressive disease that affects approximately 30% of post-head and neck radiotherapy (HNRT) patients. Results. RC mainly affects the tooth cervical areas and incisal/cuspal tips and develops 6 to 12 months after HNRT. Early RC signs include black/brownish tooth discoloration and enamel cracks, which progress to enamel delamination, exposing underlying dentin to a highly cariogenic oral environment and rapid tooth destruction/dental crown amputation. As RC advances and renders the tooth nonrestorable, it may lead to osteoradionecrosis spontaneously or upon extraction if the tooth is in a highly irradiated field of the oral cavity. This requires aggressive treatment, which would have a negative impact on a cancer survivor's quality of life and contribute to the incremental cost of cancer care. Chlorhexidine mouth rinses and topical fluoride applications are effective agents used in RC prevention; however, there are no well-established treatment protocols. Once RC progresses, dental restorations should be performed with adhesive materials in association with systematic fluoride application as illustrated in the clinical case presented in this review. Post-HNRT patients should be closely followed up for optimal RC prevention, early diagnosis, and prompt treatment. Conclusions. Future clinical studies are necessary to establish a contemporary, clinically validated protocol for RC management. (AU)

• Processo FAPESP: 18/02233-6 - Segurança oncológica no uso da fotobiomodulação intraoral e extraoral em pacientes com carcinoma espinocelular de cavidade oral e orofaringe
• Beneficiário: Alan Roger dos Santos Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
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• Beneficiário: Ana Carolina Prado Ribeiro e Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
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• Beneficiário: Alan Roger dos Santos Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 16/22862-2 - Impacto da idade sobre as toxicidades bucais induzidas pela radioterapia em pacientes jovens com câncer de boca
• Beneficiário: Jaqueline de Lima Correia
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
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• Modalidade de apoio: Bolsas no Brasil - Doutorado