Dental Pulp Status of Posterior Teeth in Patients with Oral and Oropharyngeal Cancer Treated with Concurrent Chemoradiotherapy

The Effect of Radiotherapy on Dental Pulp Status in Patients With Head and Neck Cancer: A Systematic Review.

“…This suggests that RT may not have a long-term influence on pulp vitality, and reported short-term changes in pulpal microcirculation because of RT may be temporary. But only one study by Garg et al 2015 (7) showed that no tooth (0%) responded to pulp sensitivity testing after 4-5 months of RT. It must be put in mind that this study ( 7) was performed only on maxillay and posterior teeth posterior teeth, while the other studies (3,4,6,8) included only maxillary and mandibular anterior teeth, and one study (5) included maxillary and mandibular teeth without mentioning the type.…”

“…Apparently, patients undergoing RT may exhibit a negative response to pulp sensitivity tests (7). This phenomenon could be caused by the fact that patients affected by radiation-related caries do not present dental pain on a routine basis.…”

“…Radiation side effects are mucositis, loss of taste, xerostomia, dental caries, fungal and bacterial infections, osteoradionecrosis, difficulty in speech and mastication, periodontal disease, fibrosis of soft tissues, trismus, endarteritis, hyperpigmentation of the skin surface in the field of radiation, transient hair loss, and loss of pulpal vitality. A decrease in pulp vascularity has been noted with radiotherapy (3)(4)(5)(6)(7). The determination of pulp vitality is an important step to assess the health or pathology of the pulp.…”

“…However, little is known about the direct effects of radiation on pulp status, only a few previous studies attempted to investigate the direct effects of radiation on the dental pulp, some of which revealed significant loss of pulp vitality after RT (3,(5)(6)(7). Others revealed no significant loss of pulp vitality after RT (4,8).…”

“…Others revealed no significant loss of pulp vitality after RT (4,8). Hence, there is great diversity of results when it comes to the ability of radiation to directly affect the dental pulp components and to further impair pulp vascularization and innervation, leading to clinically detectable teeth sensitivity changes to thermal and electrical stimulus, it also causes changes in the levels of oxygen saturation (3,(5)(6)(7). Considering the fact that responses of the dental pulp to thermal and electrical stimuli are directly related to the mechanisms of inflammation, microvascularization, and innervation of the dental pulp and little conflicting clinical data are available on pulp vitality after radiotherapy in head and neck malignant tumors patients; the current systematic review was performed.…”