Prosthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
J Dent. 2020 Jun;97:103343. doi: 10.1016/j.jdent.2020.103343. Epub 2020 Apr 25.
This study was conducted to examine the tooth wear status of nasopharyngeal-carcinoma (NPC) patients who had received radiotherapy at least 5-year previously, and to investigate the salivary parameters that may be associated with the tooth wear.
Tooth wear status of NPC survivors were clinically assessed using the Exact Tooth Wear Index. A tooth was graded to have severe wear when more than one-third of its buccal/occlusal/lingual surface had dentine loss. At the subject-level, percentages of anterior/posterior/all teeth with severe wear were calculated. Age, number of teeth, flow-rate/buffering capacity/pH of stimulated whole (SWS) and parotid (SPS) saliva's were collected. Correlation and multiple-linear regression tests were performed at the significance level α = 0.05.
Sixty-eight participants (mean age of 60.0 ± 8.9), 697 anterior and 686 posterior teeth were examined with a mean of 10-years post-radiotherapy. Severe tooth wear was found in 63 (92.6 percent) participants, 288 anterior and 83 posterior teeth. The mean percentage of anterior/posterior/all teeth with severe wear were 42.3 ± 28.1, 14.5 ± 19.9 and 30.0 ± 21.7. Anterior teeth, particularly the incisal surface of central incisors were most affected. The mean flow-rate of SWS and SPS were 0.1 ± 0.1 ml/min and 0.03 ± 0.07 ml/min respectively. Thirty (44.1 percent) and 48 (70.6 percent) participants were found to have low/no buffering capacity of SWS and SPS respectively. Multiple-regression analyses revealed the SWS flow-rate was associated with the percentage of anterior teeth with severe wear (p=0.03).
Anterior tooth wear is a significant dental problem among NPC survivors and was associated with hypo-salivation.
Patients with hypo-salivation should be being monitored for tooth wear particularly on the anterior teeth.
本研究旨在检查至少接受过 5 年放射治疗的鼻咽癌（NPC）患者的牙齿磨损状况，并探讨与牙齿磨损相关的唾液参数。
采用Exact Tooth Wear Index 对 NPC 幸存者的牙齿磨损状况进行临床评估。当牙的颊面/颌面/舌面有超过三分之一的牙本质丧失时，该牙被评定为严重磨损。在个体水平上，计算有严重磨损的前牙/后牙/所有牙的百分比。收集年龄、牙齿数量、刺激全唾液（SWS）和腮腺唾液（SPS）的流速/缓冲能力/pH 值。在显著性水平 α=0.05 下进行相关性和多元线性回归检验。
68 名参与者（平均年龄 60.0±8.9 岁），697 颗前牙和 686 颗后牙，放射治疗后平均随访 10 年。63 名（92.6%）参与者和 288 颗前牙和 83 颗后牙有严重的牙齿磨损。前牙、特别是中切牙切缘磨损最严重，平均有严重磨损的前牙/后牙/所有牙的百分比分别为 42.3±28.1、14.5±19.9 和 30.0±21.7。SWS 和 SPS 的平均流速分别为 0.1±0.1ml/min 和 0.03±0.07ml/min。分别有 30 名（44.1%）和 48 名（70.6%）参与者的 SWS 和 SPS 缓冲能力低/无。多元回归分析显示，SWS 流速与有严重磨损的前牙百分比相关（p=0.03）。
NPC 幸存者的前牙磨损是一个显著的口腔问题，与唾液分泌减少有关。
唾液分泌减少的患者应监测牙齿磨损情况，特别是前牙。
