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Dental Pulp Status of Posterior Teeth in Patients with Oral and Oropharyngeal Cancer Treated with Concurrent Chemoradiotherapy

Published:September 30, 2015DOI:https://doi.org/10.1016/j.joen.2015.08.006

      Abstract

      Introduction

      The absence of tooth sensitivity has been observed in patients who have undergone radiotherapy. The aim of this investigation was to evaluate the effects of concurrent chemoradiotherapy on the pulp status of posterior teeth in patients with malignant oral and oropharyngeal cancer.

      Methods

      Twenty-one patients diagnosed with malignant oral and oropharyngeal cancer undergoing concurrent chemoradiotherapy underwent cold thermal pulp sensitivity testing and electric pulp testing of 4 teeth, 1 from each quadrant, at 4 points in time (PT): before radiotherapy (PT1), after 30–35 Gy (PT2), at the end of radiotherapy at 66–70 Gy (PT3), and 4 months (PT4) after beginning radiotherapy.

      Results

      All 84 teeth tested positive to cold thermal pulp sensitivity testing at PT1 (100%) and 25 teeth at PT2. No tooth responded at PT3 and PT4 (100%). A statistically significant difference (P < .05) existed in the number of positive responses between different points in time.

      Conclusions

      Radiotherapy decreased the number of teeth responding to pulp sensitivity testing after doses greater than 30–35 Gy.

      Key Words

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      References

        • Ogle O.E.
        • Nikoyan L.
        Radiation and Chemotherapy in Oral and Maxillofacial Surgery. A Textbook of Advanced Oral and Maxillofacial Surgery.
        InTech, New York2013
        • Knowles J.C.
        • Chalian V.A.
        • Shidnia H.
        Pulp innervation after radiation therapy.
        J Prosthet Dent. 1986; 56: 708-711
        • Kataoka S.H.
        • Setzer F.C.
        • Fregnani E.R.
        • et al.
        Effects of 3-dimensional conformal or intensity-modulated radiotherapy on dental pulp sensitivity during and after the treatment of oral or oropharyngeal malignancies.
        J Endod. 2012; 38: 148-152
        • Grotz K.A.
        • Duschner H.
        • Kutzner J.
        • et al.
        Histotomography studies of direct radiogenic dental enamel changes.
        Mund Kiefer Gesichtschir. 1998; 2: 85-90
        • Keilbassa A.M.
        • Munz I.
        • Bruggmoser G.
        • Schulte-Monting J.
        Effect of demineralization and remineralization on microhardness of irradiated dentin.
        J Clin Dent. 2002; 13: 104-110
        • Barbieri E.
        • Novaes P.E.
        Principles of Radiation Therapy. Oncology for Graduation.
        2nd ed. Tecmedd, São Paulo, Brazil2006: 187-203
        • Cooper J.S.
        • Fu K.
        • Marks J.
        • Silverman S.
        Late effects of radiation therapy in the head and neck region.
        Int J Radiat Oncol Biol Phys. 1995; 31: 1141-1164
        • Shenoy V.K.
        • Shenoy K.K.
        • Rodrigues S.
        • Shetty P.
        Management of oral health in patients irradiated for head and neck cancer: a review.
        Kathmandu Univ Med J (KUMJ). 2007; 5: 117-120
        • Kataoka S.H.
        • Setzer F.C.
        • Gondim-Junior E.
        • et al.
        Pulp vitality in patients with intraoral and oropharyngeal malignant tumours undergoing radiation therapy assessed by pulse oximetry.
        J Endod. 2011; 37: 1197-1200
        • Kielbassa A.M.
        • Hinkelbein W.
        • Hellwig E.
        • Meyer-Luckel H.
        Radiation-related damage to dentition.
        Lancet Oncol. 2006; 7: 326-335
        • Fajardo L.P.
        • Berthrong M.
        • Anderson R.E.
        Radiation Pathology.
        Oxford University Press, New York2001
        • Caldeira C.L.
        • Fidel S.R.
        • Pesce H.F.
        • Aun C.E.
        Avaliacao da respostapulparaos testes de vitalidade com frioem dentes com deposicao de dentinareparativa.
        RPG Revista de Pos-graduacao (USP). 1995; 2: 157-160
        • Nickens G.E.
        • Patterson S.S.
        • El-Kafrawy A.H.
        • Hornback N.B.
        Effect of cobalt-60 radiation on the pulp of restored teeth.
        J Am Dent Assoc. 1977; 94: 701-704
        • Caldeira C.L.
        Avaliacao clınica da resposta pulpar obtida em pacientes submetidosaos testes de vitalidade com frio (gelo e diclorodifluorometano) em funcao da faixa etaria e grupo dentario [dissertacao].
        Universidade de Sao Paulo: Faculdade de Odontologia, São Paulo, Brazil1997
        • Faria K.M.
        • Brandao T.B.
        • Ribeiro A.C.
        • et al.
        Micromorphology of the dental pulp is highly preserved in cancer patients who underwent head and neck radiotherapy.
        J Endod. 2014; 40: 1553-1559
        • Weisleder R.
        • Yamauchi S.
        • Caplan D.J.
        • et al.
        The validity of pulp testing: a clinical study.
        J Am Dent Assoc. 2009; 140: 1013-1017
        • Narhi M.
        The neurophysiology of the teeth.
        Dent Clin North Am. 1990; 34: 439-448
        • Wakisaka S.
        Neuropeptides in the dental pulp: distribution, origins, and correlation.
        J Endod. 1990; 16: 67-69
        • De Swert Ko
        • Joos G.F.
        Extending the understanding of sensory neuropeptides.
        Eur J Pharmacol. 2006; 533: 171-181
        • Kim S.
        Neurovascular interactions in the dental pulp in health and inflammation.
        J Endod. 1990; 16: 48-53
        • Ahlquist M.
        • Franzen O.
        Pulpal ischemia in man: effects on detection threshold, A-delta neural response and sharp dental pain.
        Endod Dent Traumatol. 1999; 15: 6-16
        • Seifrtová M.
        • Havelek R.
        • Cmielova J.
        • et al.
        The response of human ectomesenchymal dental pulp stem cells to cisplatin treatment.
        Int Endod J. 2012; 45: 401-412
        • Gurushanthaiah D.
        • Knoblock R.
        • Haller J.R.
        Intra-arterial effects of cisplatin on microvascular anastomosis in the rat model.
        Laryngoscope. 2002; 112: 1456-1458
        • Meirow D.
        • Dor J.
        • Kaufman B.
        • et al.
        Cortical fibrosis and blood-vessels damage in human ovaries exposed to chemotherapy. Potential mechanisms of ovarian injury.
        Hum Reprod. 2007; 22: 1626-1633
        • Ng Y.L.
        • Mann V.
        • Rahbaran S.
        • et al.
        Outcome of primary root canal treatment: systematic review of the literature—part 1. Effects of study characteristics on probability of success.
        Int Endod J. 2007; 40: 921-939