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Systematic review and meta-analysis on physical barriers to prevent root dentin demineralization. Sci Rep 2022; 12:18194. [PMID: 36307461 PMCID: PMC9616813 DOI: 10.1038/s41598-022-22132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/10/2022] [Indexed: 12/31/2022] Open
Abstract
The present review systematically analyzed in vitro and in situ studies investigating physical diffusion barriers (sealants, desensitizer or adhesives) to prevent the development or the progression of root (dentin) demineralization. Three electronic databases (PubMed-Medline, CENTRAL, Ovid-EMBASE) were screened for studies from 1946 to 2022. Cross-referencing was used to identify further articles. Article selection and data abstraction were done in duplicate. Languages were not restricted. The type of outcome was not restricted, and their mean differences (MD) were calculated using fixed- or random-effects models. Risk of Bias was graded using Risk of Bias 2.0 tool. From 171 eligible studies, 34 were selected for full-text analysis evaluating 69 different materials, and 17 studies-still evaluating 36 different materials-were included (3 in situ and 14 in vitro). Ten studies evaluated desensitizers; 8 adhesives; and 1 infiltration. Meta-analyses were possible for all 17 studies. Meta-analyses revealed that lesion depth after no treatment was significantly higher than after the application of single-step adhesives (MD[95%CI] = - 49.82[- 69.34; - 30.30]) and multi-step adhesives (MD[95%CI]=-60.09 [-92.65, -27.54]). No significant differences in the lesion depth increase between single- and multi-step adhesives could be observed (MD[95%CI]=30.13 [-21.14, 81.39]). Furthermore, compared to no treatment the increase of the lesion depth was significantly hampered using desensitizers (MD[95%CI] = - 38.02[- 51.74; - 24.31]). Furthermore, the included studies presented unclear or high risk. A physical diffusion barrier can significantly hamper the increase of lesion depth under cariogenic conditions. Furthermore, multi-step adhesives seem not to be more effective than single-step adhesives. However, this conclusion is based on only few in vitro and in situ studies.
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Tasaka S, Jingu K, Takahashi N, Umezawa R, Yamamoto T, Ishikawa Y, Takeda K, Suzuki Y, Kadoya N. The Long-Term Recovery of Parotid Glands in Nasopharyngeal Carcinoma Treated by Intensity-Modulated Radiotherapy. Front Oncol 2021; 11:665837. [PMID: 34026643 PMCID: PMC8138171 DOI: 10.3389/fonc.2021.665837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/19/2021] [Indexed: 12/04/2022] Open
Abstract
Background Xerostomia is one of the most common adverse events of radiotherapy in head and neck cancer patients. There have been many reports on functional changes of the parotid gland after radiation therapy, but there have been few reports on the volume of the parotid gland and its relationship with oral quality of life (QOL) and even fewer reports on longitudinal change of the parotid gland volume. The purpose of this study was to evaluate the long-term change of the parotid gland volume after intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma and the relationship between parotid irradiation dose and xerostomia symptoms. Methods We retrospectively analyzed 26 patients with nasopharyngeal cancer treated by IMRT. Longitudinal changes of parotid gland volumes after IMRT were evaluated on CT images. The parotid gland volumes in each period were converted to the ratio to parotid gland volumes before radiotherapy (relative parotid volume). Dunnett’s test was used to evaluate the longitudinal changes in relative parotid volumes at 0-6, 7-18, 19-30, 31-42, 43-54 and 55-66 months after IMRT. We assessed xerostomia 3 years or more after IMRT by measuring the degree of oral moisture using a moisture-checking device (Mucus, Life Co., Ltd.) and oral QOL evaluation by GOHAI (General Oral Health Assessment Index). Results The relative parotid volumes during radiotherapy and at 0-6, 7-18, 19-30, 31-42, 43-54 and 55-66 months after IMRT were 75.2 ± 14.3%, 67.2 ± 11.4%, 68.5 ± 15.9%, 72.4 ± 14.8%, 73.0 ± 13.8%, 76.2 ± 17.5%, and 77.1% ± 17.3%, respectively. The parotid volume had recovered significantly at 43-54 and 55-66 months after IMRT, especially in parotids receiving less than 40 Gy as the mean dose. The mean irradiated dose for bilateral parotids showed negative correlations with oral QOL score and oral moisture after a long period. Conclusions The parotid volume recovered gradually but had not reached a plateau even 3 years after radiotherapy, especially in parotids receiving less than 40 Gy as the mean dose.
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Affiliation(s)
- Shun Tasaka
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Suzuki
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Duruk G, Acar B, Temelli Ö. Effect of different doses of radiation on morphogical, mechanical and chemical properties of primary and permanent teeth-an in vitro study. BMC Oral Health 2020; 20:242. [PMID: 32873280 PMCID: PMC7465328 DOI: 10.1186/s12903-020-01222-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background Radiotherapy, applied to the head and neck region, can cause radiation side effects such as reduction of saliva and radiation caries. The aim of this study was to perform an in vitro assessment of the effects of radiation therapy on the morphological, mechanical, and chemical properties of primary and permanent teeth. Methods One hundred four extracted human teeth (52 impacted wisdom teeth, 52 primary molar teeth) were used. The teeth were divided into two parts in the mesiodistal direction. Of the 98 teeth, the vestibular sections were used for the vickers analysis and lingual sections were used for the Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES) analysis. The teeth in the experimental group were fixed to wax models. Each model had an equal number of teeth (n = 7). The doses were applied to the teeth for 6 weeks; 5 week days and 2Gy daily. After the radiotherapy was conducted weekly, a wax model was taken from radiation reception. Along with the elemental contents (Na, K, Mg, P, and Ca) of the teeth, enamel and dentin microhardness was evaluated, and SEM analyzes were performed on 6 teeth. Results Radiation caused a decrease in microhardness of enamel and dentin (p < 0.05). In the elemental analysis by ICP-OES, it was observed that there were decreases in all elements after 60Gy compared to the control group (p < 0.05). In the experimental groups, amorphous structures were encountered in SEM images. Conclusions Radiation has negative effects on the teeth structure and additional studies are needed in this regard. This study indicates that radiotherapy patients are at a higher risk for dental caries.
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Affiliation(s)
- Gülsüm Duruk
- Department of Pediatric Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkey.
| | - Burçin Acar
- Department of Pediatric Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Öztun Temelli
- Department of Radiation Oncology, Faculty of Medicine, Inonu University, Malatya, Turkey
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Campos Velo MMDA, Farha ALH, da Silva Santos PS, Shiota A, Sansavino SZ, Souza ATF, Honório HM, Wang L. Gamma radiation increases the risk of radiation-related root dental caries. Oral Oncol 2017. [PMID: 28648361 DOI: 10.1016/j.oraloncology.2017.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Marilia Mattar de Amoêdo Campos Velo
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al. Dr Otávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil.
| | - Ana Laura Herrera Farha
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al. Dr Otávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil.
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Al. Dr Otávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil.
| | - Aymée Shiota
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al. Dr Otávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil.
| | - Simone Zuquerato Sansavino
- Radiotherapy Center of the Region of Bauru - Section of Medical Physics, Rua Prof Nair Araujo Antunes 1-50, Bauru, SP, Brazil.
| | - Ana Tarsila Fonseca Souza
- Radiotherapy Center of the Region of Bauru - Section of Medical Physics, Rua Prof Nair Araujo Antunes 1-50, Bauru, SP, Brazil.
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Dr Otávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil.
| | - Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Al. Dr Otávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil.
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Villa A, Sonis S. Toxicities associated with head and neck cancer treatment and oncology-related clinical trials. Curr Probl Cancer 2016; 40:244-257. [DOI: 10.1016/j.currproblcancer.2016.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 12/21/2022]
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Galvão-Moreira LV, da Cruz MCFN. Dental demineralization, radiation caries and oral microbiota in patients with head and neck cancer. Oral Oncol 2015; 51:e89-90. [PMID: 26541209 DOI: 10.1016/j.oraloncology.2015.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
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Santos-Silva AR, Feio PDSQ, Vargas PA, Correa MEP, Lopes MA. cGVHD-Related Caries and Its Shared Features with Other 'Dry-Mouth'-Related Caries. Braz Dent J 2015; 26:435-40. [DOI: 10.1590/0103-6440201300200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/02/2015] [Indexed: 11/22/2022] Open
Abstract
<p>Several systemic diseases and their medical treatment may predispose the development of aggressive dental caries. Head and neck radiotherapy, chemotherapy, Sjögren's syndrome and long-standing treatment with drugs that induce hyposalivation are some of these conditions. The aim of this article is to describe the clinical features of five patients who developed chronic graft-versus-host-disease (cGVHD) as a complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and, in spite of close dental follow-up, subsequently developed rampant caries. In these cases, the restorations showed early failure and the caries still progressed until generalized teeth destruction. The majority of the teeth therefore had to be extracted due to advanced dental caries and rapid clinical progression. Herein the term "cGVHD-related caries" is proposed to describe this under-recognized complication of cancer treatment that may evolve in allo-HSCT recipients that develop cGVHD. This condition is poorly recognized in the literature and may represent the final result of the clustering of oral complications in cGVHD patients, including mucositis, oral pain, hyposalivation, taste loss and oral infections, leading to rampant caries due to impaired oral hygiene and increased intake of highly cariogenic food. Consequently, the knowledge of this oral complication should improve the medical and dental management of cGVHD oral manifestations and improve the quality of life of patients with this post allo-HSCT complication.</p>
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Cohen LE, Gordon JH, Popovsky EY, Gunawardene S, Duffey-Lind E, Lehmann LE, Diller LR. Late effects in children treated with intensive multimodal therapy for high-risk neuroblastoma: High incidence of endocrine and growth problems. Bone Marrow Transplant 2014; 49:502-8. [DOI: 10.1038/bmt.2013.218] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 11/22/2013] [Accepted: 11/25/2013] [Indexed: 11/09/2022]
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Development and evaluation of a Perspex anthropomorphic head and neck phantom for three dimensional conformal radiation therapy (3D-CRT). JOURNAL OF RADIOTHERAPY IN PRACTICE 2013. [DOI: 10.1017/s1460396912000453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPurposesTo design, construct and evaluate an anthropomorphic head and neck phantom for the dosimetric evaluation of 3D-conformal radiotherapy (3D-CRT) dose planning and delivery, for protocols developed by the Radiation Therapy Oncology Group (RTOG).Materials and methodsAn anthropomorphic head and neck phantom was designed and fabricated using Perspex material with delineated planning target volumes (PTVs) and organs at risk (OARs) regions. The phantom was imaged, planned and irradiated conformally by a 3D-CRT plan. Dosimetry within the phantom was assessed using thermoluminescent dosimeters (TLDs). The reproducibility of phantoms and TLD readings were checked by three repeated identical irradiations. Subsequent three clinical 3D-CRT plans for nasopharyngeal patients have been verified using the phantom. Measured doses from each dosimeter were compared with those acquired from the treatment planning system (TPS).ResultsPhantom's measured doses were reproducible with <3·5% standard deviation between the three TLDs’ repeated measurements. Verification of three head and neck 3D-CRT patients’ plans was implemented, and good agreement between measured values and those predicted by TPS was found. The percentage dose difference for TLD readings matched those corresponding to the calculated dose to within 4%.ConclusionThe good agreement between predicted and measured dose shows that the phantom is a useful and efficient tool for 3D-CRT technique dosimetric verification.
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Hey J, Setz J, Gerlach R, Janich M, Hildebrandt G, Vordermark D, Gernhardt CR, Kuhnt T. Parotid gland-recovery after radiotherapy in the head and neck region--36 months follow-up of a prospective clinical study. Radiat Oncol 2011; 6:125. [PMID: 21951317 PMCID: PMC3201902 DOI: 10.1186/1748-717x-6-125] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 09/27/2011] [Indexed: 11/25/2022] Open
Abstract
Background The aim of the present study was to evaluate the recovery potential of the parotid glands after using either 3D-conformal-radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) by sparing one single parotid gland. Methods Between 06/2002 and 10/2008, 117 patients with head and neck cancer were included in this prospective, non-randomised clinical study. All patients were treated with curative intent. Salivary gland function was assessed by measuring stimulated salivary flow at the beginning, during and at the end of radiotherapy as well as 1, 6, 12, 24, and 36 months after treatment. Measurements were converted to flow rates and normalized relative to rates before treatment. Mean doses (Dmean) were calculated from dose-volume histograms based on computed tomographies of the parotid glands. Results Patients were grouped according to the Dmean of the spared parotid gland having the lowest radiation exposure: Group I - Dmean < 26 Gy (n = 36), group II - Dmean 26-40 Gy (n = 45), and group III - Dmean > 40 Gy (n = 36). 15/117 (13%) patients received IMRT. By using IMRT as compared to 3D-CRT the Dmean of the spared parotid gland could be significantly reduced (Dmean IMRT vs. 3D-CRT: 21.7 vs. 34.4 Gy, p < 0.001). The relative salivary flow rates (RFSR) as a function of the mean parotid dose after 24 and 36 months was in group I 66% and 74%, in group II 56% and 49%, and in group III 31% and 24%, respectively. Multiple linear regression analyses revealed that the parotid gland dose and the tumor site were the independent determinants 12 and 36 months after the end of RT. Patients of group I and II parotid gland function did recover at 12, 24, and 36 months after the end of RT. Conclusions If a Dmean < 26 Gy for at least one parotid gland can be achieved then this is sufficient to reach complete recovery of pre-RT salivary flow rates. The radiation volume which depends on tumor site did significantly impact on the Dmean of the parotids, and thus on the saliva flow and recovery of parotid gland.
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Affiliation(s)
- Jeremias Hey
- Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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