Fonsêca Jéssica-Montenegro, Palmier Natália-Rangel, Silva Wagner-Gomes, Faria Karina-Morais, Vargas Pablo-Agustin, Lopes Marcio-Ajudarte, Salvajoli João-Victor, Brandão Thais-Bianca, Ribeiro Ana-Carolina-Prado, Almeida José-Flávio-Affonso, De Goes Mario-Fernando, Santos-Silva Alan-Roger
Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil.
Serviços de Odontologia e Radioterapia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil.
J Clin Exp Dent. 2019 Mar 1;11(3):e236-e243. doi: 10.4317/jced.55370. eCollection 2019 Mar.
Radiation-related caries (RRC) is one of the most significant oral toxicities of head and neck radiotherapy (HNRT); however, the potential of radiation to directly cause harmful dentin and pulpal effects and impair response to caries progression is controversial.
Therefore, the aim of this study was to characterize the reactions of the dentin-pulp complex in teeth affected by RRC. Patients and methods: Twenty-two carious teeth extracted from 22 head and neck cancer (HNC) patients were divided into control (conventional caries; n=11) and irradiated (RRC; n=11) groups and paired matched by dental homology, clinical patterns of caries progression following the Post-Radiation Dental Index (PRDI) and microscopic depth of carious invasion. Histopathological characteristics based on morphological hierarchy, cell populations of dental pulp, blood vessels, neural elements, extracellular matrix components, inflammation, patterns of carious invasion and reactionary dentin presence were evaluated by optical light microscopy and histomorphometry.
Mean PRDI scores were 3.2 for the control group and 3.8 for the irradiated group. Dentin demineralization patterns were also similar between the groups and the mean depths of demineralization were 1,158.58µm and 1,056.89µm for the control and irradiated groups, respectively.
Pulp histopathological changes and dentin reaction patterns were similar between groups and varied according to the PRDI scores and carious lesions depth. Dentin and pulp reactions are highly preserved in RRC teeth. Cancer, radiotherapy, radiation-related caries, teeth, pulp.
放射性龋齿（RRC）是头颈部放疗（HNRT）最严重的口腔毒性反应之一；然而，辐射直接导致牙本质和牙髓产生有害影响以及损害龋齿进展反应的可能性存在争议。
因此，本研究的目的是描述受RRC影响牙齿中牙本质-牙髓复合体的反应。患者与方法：从22名头颈部癌（HNC）患者中拔除的22颗龋齿被分为对照组（传统龋齿；n = 11）和照射组（RRC；n = 11），并根据牙齿同源性、放疗后牙科指数（PRDI）及龋齿侵袭的微观深度进行配对匹配。通过光学显微镜和组织形态计量学评估基于形态层次、牙髓细胞群体、血管、神经成分、细胞外基质成分、炎症、龋齿侵袭模式及反应性牙本质存在情况的组织病理学特征。
对照组的平均PRDI评分为3.2，照射组为3.8。两组间牙本质脱矿模式也相似，对照组和照射组的平均脱矿深度分别为1158.58μm和1056.89μm。
两组间牙髓组织病理学变化和牙本质反应模式相似，并根据PRDI评分和龋损深度而有所不同。RRC牙齿中的牙本质和牙髓反应高度保留。癌症、放疗、放射性龋齿、牙齿、牙髓。
