Effects of 3-Dimensional Conformal or Intensity-modulated Radiotherapy on Dental Pulp Sensitivity during and after the Treatment of Oral or Oropharyngeal Malignancies

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

“…In the included articles, the age of the patients were from 40-74 years old without mentioning the prevalence of patient's sex in 4 studies, one study (7) didn't mention the sex included in the study, only one study (6) showed the prevalence of male patients. The races of population in this study were in Indian (7) and Brazilian people (3,4,6,8). Thus, that finding recommends doing clinical studies on more races of population.…”

“…Radiation therapy (RT) is part of the treatment of malignant tumors because of the ability of ionizing radiation to control cell growth. However, to reach target cells, radiation will have to pass through healthy tissues, which may damage the DNA of normal cells (3). 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.…”

“…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.…”