Lăcătuşu S, Frâncu D, Frâncu L
Department of Odontology, University of Medicine and Pharmacy Gr. T. Popa, Iassy.
Rev Med Chir Soc Med Nat Iasi. 1996 Jul-Dec;100(3-4):193-7.
Studying through clinical and laboratory means the bucco-dental status of the 28 patients who followed radiotherapeutical cures in the cervico-facial territory, the authors establish the apparition, at different periods of time, of the rampant caries. The rampant caries have been found in 46.42 percent of the cases, especially in patients exposed to prolonged or repeated cures of cervico-facial radiotherapy (88.88 percent) and concern the cervical zones, incisal edges and cusps, zones that are usually resistant at caries. The appearance and the severity of these types of caries are correlated with: a) the degree of reduction of the repose and stimulated salivary flow; b) the maintaining time of the low salivary flow that is dependent on the received X-ray dose and the number of cures; c) the association with sweet-drinks intake; d) the manner of effectuation of the bucco-dental hygiene; e) the setting-up or not of the some prevention measures. There are presented some preventive measures that must be set-up in this category of patients and treatment-protocols, that can be applied in the clinical situations of appearance of rampant caries after the irradiant treatment of the head and neck. The authors recommend the compulsory use of the prophylactic treatment and suggest a suitable plan of treatment that includes the reduction of microbial flora, the change of the alimentary diet, and salivary stimulates and substitutes. These measures can avoid the apparition of rampant caries, which will require ample restoration. The conclusions emphasize the fact that exists real possibilities of protection and treatment for these types of caries, depending on the clinical status of patient and the disease prognosis, when exists a tight collaboration between the radiotherapist, patients, and dentist.
通过临床和实验室手段研究28例接受头颈部放疗患者的口腔牙齿状况，作者确定了猖獗龋在不同时间段的出现情况。猖獗龋在46.42%的病例中被发现，尤其在接受长时间或反复头颈部放疗的患者中（88.88%），且涉及颈部区域、切缘和牙尖，这些区域通常对龋齿有抵抗力。这类龋齿的出现和严重程度与以下因素相关：a）静息和刺激唾液流量减少的程度；b）低唾液流量的持续时间，其取决于所接受的X射线剂量和治疗次数；c）与饮用甜饮料的关联；d）口腔牙齿卫生的实施方式；e）是否采取了一些预防措施。文中介绍了这类患者必须采取的一些预防措施以及治疗方案，这些方案可应用于头颈部放疗后出现猖獗龋的临床情况。作者建议强制使用预防性治疗，并提出一个合适的治疗计划，包括减少微生物菌群、改变饮食、刺激唾液分泌和使用唾液替代品。这些措施可避免猖獗龋的出现，否则将需要大量修复。结论强调，当放疗医生、患者和牙医紧密合作时，根据患者的临床状况和疾病预后，对于这类龋齿确实存在保护和治疗的可能性。
