Schweyen R, Hey J, Fränzel W, Vordermark D, Hildebrandt G, Kuhnt T
Universitätspoliklinik für Prothetik, Martin-Luther-Universität Halle-Wittenberg, Halle-Wittenberg, Deutschland.
Strahlenther Onkol. 2012 Jan;188(1):21-8. doi: 10.1007/s00066-011-0011-1. Epub 2011 Dec 23.
After radiation treatment of head-and-neck cancer, the impairment of patient's quality of life still remains an issue. After completion of the treatment course, a substantial number of patients develop so-called radiation caries. In addition, almost 50% of all cases of infectious osteoradionecrosis (iORN) of the jaws are directly associated with radiation caries. This review addresses our current knowledge on the etiology and pathogenesis of radiation caries including possible preventive strategies.
A PubMed search using the terms "radiation caries" ("radiation related caries", "radiation related damage to dentition") and "radiogenic caries" ("postradiation caries", "dental complications and radiotherapy") was performed. The analysis of its content focused on the etiology, the pathogenesis, and the available knowledge on prophylaxis as well as treatment of radiation caries.
For this review, 60 publications were selected. As main causal factors for radiogenic caries, either indirect impairment, resulting from alterations in the oral environment (e.g., radiation-induced xerostomia) or direct radiation-induced damage in teeth hard tissues are discussed. Radiation caries remains a lifelong threat and, therefore, requires permanent prevention programs.
To enable optimal medical care of the patients during the time course of radiotherapy as well as afterwards, close interdisciplinary cooperation between radiotherapists, oral surgeons, otorhinolaryngologists, and dentists is absolutely essential.
头颈部癌放疗后，患者生活质量受损仍是一个问题。在治疗疗程结束后，相当数量的患者会出现所谓的放射性龋。此外，颌骨感染性放射性骨坏死（iORN）的所有病例中，近50%与放射性龋直接相关。本综述阐述了我们目前关于放射性龋病因和发病机制的知识，包括可能的预防策略。
使用“放射性龋”（“辐射相关龋”、“辐射相关牙列损伤”）和“放射性致龋”（“放疗后龋”、“牙科并发症与放疗”）等术语在PubMed上进行检索。对其内容的分析集中在放射性龋的病因、发病机制以及预防和治疗方面的现有知识。
本综述选择了60篇文献。作为放射性致龋的主要病因，讨论了口腔环境改变（如放疗引起的口干症）导致的间接损害或牙齿硬组织的直接辐射损伤。放射性龋仍然是终身威胁，因此需要长期的预防方案。
为了在放疗期间及之后为患者提供最佳医疗护理，放疗科医生、口腔外科医生、耳鼻喉科医生和牙医之间密切的跨学科合作绝对至关重要。
