Radiation-induced caries as the late effect of radiation therapy in the head and neck region

Abstract

Overall improvement in the nationwide system of medical services has consequently boosted the number of successfully treated patients who suffer from head and neck cancer. It is essential to effectively prevent development of radiation-induced caries as the late effect of radiation therapy. Incidence and severity of radiationinduced changes within the teeth individually vary depending on the patient's age, actual radiation dose, size of radiation exposure field, patient's general condition and additional risk factors. Inadequately managed treatment of caries may lead to loss of teeth, as well as prove instrumental in tangibly diminishing individual quality of life in patients. Furthermore, the need to have the teeth deemed unyielding or unsuitable for the application of conservative methods of treatment duly extracted is fraught for a patient with an extra hazard of developing osteoradionecrosis (ORN), while also increasing all attendant therapeutic expenditures. The present paper aims to offer some practical insights into currently available methods of preventing likely development of radiation-induced caries.

Effect of carbodiimide and chlorhexidine on the bond strength longevity of resin cement to root dentine after radiation therapy

“…Radiation carious lesions are one of the major complications, differing from conventional lesions by their rapid progression and because they affect surfaces normally free of caries, such as cusp tips and exposed surfaces (Silva et al 2009, Lieshout & Bots 2014, Gupta et al 2015, Dobro s et al 2016, leading to severe tooth destruction (Gupta et al 2015, Dobro s et al 2016 which, in extreme cases, entails the total destruction of the originally healthy dentition within a short time (Dobro s et al 2016), besides causing pulpal and periradicular alterations (Gupta et al 2015, Dobro s et al 2016. In these cases, surgical procedures are restricted because of the risk of osteoradionecrosis (Moon et al 2017), and all attempts are made to maintain even teeth that have total loss of coronal structure (Aggarwal 2009), necessitating root canal treatment and use of intraradicular posts (Aggarwal 2009, Moon et al 2017, Yamin et al 2018.…”

Longevity of bond strength of resin cements to root dentine after radiation therapy

“…, Dobroś et al . ). Considering the structural and chemical changes of teeth caused by radiotherapy during head and neck cancer treatment and the increase of survival and cure of these patients, tooth restoration becomes an important factor to improve the quality of life.…”

“…), xerostomia (Dobroś et al . ), mandibular osteoradionecrosis, muscular atrophy, trismus (Beech et al . ), changes in bacterial microbiota (Khaw et al .…”

“…In the oral cavity, the side effects of radiotherapy are related to loss of taste, fungal infections and mucositis (Khaw et al 2014), xerostomia (Dobro s et al 2016), mandibular osteoradionecrosis, muscular atrophy, trismus (Beech et al 2014), changes in bacterial microbiota (Khaw et al 2014) and chemical (De S a Ferreira et al 2016) and structural changes in enamel and dentine (Soares et al 2010, Gonc ßalves et al 2014. These alterations are associated with the quantitative and qualitative reduction of saliva, and the difficulty of hygiene of the oral cavity due to the development of mucositis and muscular rigidity (Khaw et al 2014), which favour the appearance and progression of radiation cavities (Gupta et al 2015, Dobro s et al 2016.…”

“…Radiation cavities cause rapid and severe destruction of enamel and dentine in patients who have undergone head and neck radiotherapy, compromising the pulp and periradicular tissues (Gupta et al 2015, Dobro s et al 2016. Considering the structural and chemical changes of teeth caused by radiotherapy during head and neck cancer treatment and the increase of survival and cure of these patients, tooth restoration becomes an important factor to improve the quality of life.…”