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

• Jéssica Montenegro Fonseca ^[3] ; Cristhian Camilo Madrid Troconis ^[4] ; Natália Rangel Palmier ^[3] ; Wagner Gomes-Silva ^[1] ; Mariana de Pauli Paglioni ^[3] ; Anna Luiza Damaceno Araújo ^[3] ; Lady Paola Aristizábal Arboleda ^[3] ; Aljomar José Vechiato Filho ^[1] ; Wilfredo Alejandro González-Arriagada ^[2] ; Mario Fernando de Goes ^[4] ; Márcio Ajudarte Lopes ^[3] ; Thaís Bianca Brandão ^[1] ; Pablo Agustin Vargas ^[3] ; Ana Carolina Prado Ribeiro ^[5]
  1. [1] Universidade de São Paulo

     Universidade de São Paulo

     Brasil

     
  2. [2] Universidad de Valparaíso

     Universidad de Valparaíso

     Valparaíso, Chile

     
  3. [3] Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
  4. [4] Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas (UNICAMP) Piracicaba, São Paulo, Brazil
  5. [5] Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

  Mostrar afiliaciones +
• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 25, Nº. 1 (January), 2020
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • 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.

    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.

    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.

    HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination.