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[口腔治疗性照射中牙科合金导致剂量增强的体内测定]

[The in-vivo determination of dosage intensification due to dental alloys in the therapeutic irradiation of the oral cavity].

作者信息

Thilmann C, Adamietz I A, Rahn R, Mose S, Saran F, Schopohl B, Böttcher H D

机构信息

Abteilung für Strahlentherapie, Zentrum der Zahn-, Mund- und Kieferheilkunde, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt a. M.

出版信息

Strahlenther Onkol. 1995 Aug;171(8):468-72.

PMID:7652670
Abstract

BACKGROUND

In the course of therapeutic irradiation of regions in the mouth cavity dosage increase due to the emission of secondary electrons in the vicinity of dental materials can be observed. This could induce local destruction of the mucous membrane in contact with metallic dental crowns and fillings. As at now, only rough estimates of this dosage increase could be made with the help of measurements carried out with models.

PATIENTS AND METHODS

The degree of dosage increase in the immediate surrounding of metallic dental material was measured in an in-vivo study during therapeutic irradiation with 60Co gamma rays in the area of mouth cavity of 11 patients. Measurements were carried out by thermoluminescent dosimetry at permanently fixed golden teeth and alloy specimens containing gold and palladium and amalgam.

RESULTS

The following relative dosage values according to a simultaneously measured reference value were measured at the surface of the different dental materials: 161% near fixed golden caps, 168% near the specimen containing gold in a high percentage, 133% near the specimen of palladium and 161% near the specimen of amalgam.

CONCLUSION

The in vivo measured dosage increases due to metallic dental prosthesis are less than values obtained using back scatter arrangements for irradiating phantoms. Despite this, they could be of clinical relevance. Thus the usage of a mucous membrane protection during irradiation with 60Co, as a means of preventing local lesions of the oral mucosa, due to dental alloys within the treatment volume remains inevitable.

摘要

背景

在口腔区域的放射治疗过程中,可以观察到由于牙科材料附近二次电子的发射导致剂量增加。这可能会引起与金属牙冠和填充物接触的黏膜局部破坏。到目前为止,只能借助模型测量对这种剂量增加进行粗略估计。

患者和方法

在一项体内研究中,对11名患者口腔区域用60Coγ射线进行放射治疗期间,测量了金属牙科材料紧邻区域的剂量增加程度。通过热释光剂量测定法,在永久固定的金牙以及含金和钯的合金标本和汞合金上进行测量。

结果

根据同时测量的参考值,在不同牙科材料表面测得以下相对剂量值:在固定金冠附近为161%,在高含金比例的标本附近为168%,在钯标本附近为133%,在汞合金标本附近为161%。

结论

体内测量得出的因金属牙修复体导致的剂量增加小于使用反向散射装置照射体模所获得的值。尽管如此,它们仍可能具有临床相关性。因此,在使用60Co进行放射治疗期间,使用黏膜保护措施作为预防治疗区域内牙科合金导致口腔黏膜局部病变的手段仍然是必不可少的。

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