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标准和改良放疗方案对硬牙组织表面结构的直接诱导效应。

Direct Induced Effects of Standard and Modified Radiotherapy Protocol on Surface Structure of Hard Dental Tissue.

作者信息

Klarić Sever Eva, Tarle Andro, Vukelja Josipa, Soče Majana, Grego Timor

机构信息

Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine Zagreb.

Health Center Centar, Zagreb.

出版信息

Acta Stomatol Croat. 2021 Dec;55(4):334-345. doi: 10.15644/asc55/4/1.

Abstract

INTRODUCTION

Radiotherapy is used to treat neo plasmatic lesions and the common side effects of this process are pain, swelling and sensitivity of mucous membranes in domain of radiation, reduced salivation, caries, and periodontal disease and, in total, low life quality. The purpose of this research was to estimate the outcome of direct irradiation on physical and surface characteristics of hard dental tissues.

MATERIALS AND METHODS

Twenty, caries free third molars were involved in the research. Prior to different submission protocols, tooth halves were randomly assigned to subject and control groups by using a draw method. The first group (n=20) was submitted to conventional irradiation protocol (2 Gy for 35 days), second group (n=20) was submitted to one powerful, exploratory dose of 70 Gy. Each sample served as its own control. Radiation was performed with a linear accelerator radiotherapy unit. The surface microhardness and roughness were measured at the beginning (initially), and upon completion of irradiation procedure. The average change in microhardness and roughness after different treatments was compared by t-test for independent samples. Normality was tested by the Shapiro-Wilk test.

RESULTS

Significant differences were found after the standard radiation protocol and the exploratory dose of 70 Gy, with decreased mean microhardness and increased mean roughness (p<0.001) of both hard dental tissues. Enamel and dentin surface microhardness and roughness did not vary notably with regards to different irradiation protocols.

CONCLUSION

Head and neck conventional irradiation protocol leads to possible breakdown of enamel and dentin with reduced microhardness and increased surface roughness regardless of used irradiation protocol.

摘要

引言

放射疗法用于治疗肿瘤性病变,该过程的常见副作用包括放射区域内的疼痛、肿胀以及黏膜敏感、唾液分泌减少、龋齿和牙周疾病,总体而言生活质量较低。本研究的目的是评估直接照射对硬牙组织物理和表面特征的影响。

材料与方法

本研究使用了20颗无龋的第三磨牙。在采用不同的照射方案之前,通过抽签法将牙半随机分为实验组和对照组。第一组(n = 20)采用传统照射方案(35天内给予2 Gy),第二组(n = 20)给予一次70 Gy的高剂量探索性照射。每个样本自身作为对照。使用直线加速器放射治疗装置进行照射。在照射开始时(初始)以及照射程序完成后测量表面显微硬度和粗糙度。通过独立样本t检验比较不同处理后显微硬度和粗糙度的平均变化。通过Shapiro-Wilk检验测试正态性。

结果

在标准放射方案和70 Gy的探索性剂量照射后发现了显著差异,两种硬牙组织的平均显微硬度降低,平均粗糙度增加(p < 0.001)。釉质和牙本质表面显微硬度和粗糙度在不同照射方案下没有明显差异。

结论

无论采用何种照射方案,头颈部传统照射方案都可能导致釉质和牙本质破坏,显微硬度降低,表面粗糙度增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/525a/8734449/a27697761bbe/ASC_55(4)_334-345-f1.jpg

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