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

Abstract

Background: 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. Material and Methods: 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. Results: 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

Dosimetric Comparison between Volumetric Modulated Arc Therapy (VMAT) and Intensity-Modulated Radiotherapy (IMRT) for Dental Structures of Head and Neck Cancer Patients

“…The mechanism of RRC includes two aspects: direct factors and indirect factors [ 25 ]. Concerning direct factors, radiation can lead to changes in the mechanical properties and chemical composition of teeth, directly destroying the enamel, dentin, and the dentinoenamel junction [ 8 , 26 , 27 ]. Although most people believe that direct factors play a significant role in forming radiation-related caries, direct damage to the teeth by radiation is still not negligible.…”

Os impactos da radioterapia na estrutura dental e suas consequências no tratamento odontológico

“…Lu et al, (2019) descreve que na junção dentina-esmalte (JDE) as fissuras ficaram evidentes com o aumento das doses e que na exposição de 30Gy alterações na microdureza e módulo de elasticidade puderam ser observadas próxima a região JDE. Não houve diferenças aparentes nas tensões de tração e cisalhamento entre o grupo controle e radiação in vitro, provavelmente devido à observação de que a radiação in vitro aumentou o módulo de elasticidade de todas as regiões de esmalte incluindo o JDE (Fonseca et al, 2020) Siripamidul et al, (2022) explica que a diferença entre a microdureza na junção cemento-esmalte (JCE) foi maior do que na região da JDE. Isso porque a quantidade e o diâmetro dos túbulos dentinários no nível da JCE são maiores e mais largos, em comparação com os da junção dentina-esmalte.…”

Toxicological Risks of the Cobalt–Chromium Alloys in Dentistry: A Systematic Review

“…As the current systematic review deals with both in vitro and in vivo, one risk assessment was performed for each type. Regarding the in vitro studies, the process was adapted following two previous systematic reviews based on in vitro studies [ 9 , 10 ] because there is no known assessment method for this kind of study. Two authors (B.G.…”