Manejo de la caries relacionada con la radiación en pacientes con cancer de cabeza y cuello: Evidencia científica
DOI:
https://doi.org/10.33448/rsd-v10i7.16733Palabras clave:
Caries Dental; Dentina; Esmalte Dental; Neoplasias de la Boca; Radioterapia.Resumen
Apesar de la eficacia em la erradicatión de células cancerosas, la radioterapia de cabeza y cuello puede llegar a los tejidos sanos cercanos al tumor, provocando efectos indeseables en el paciente, como hiposalivación, sequedad de boca, mucositis, necrosis de tejidos y caries relacionadas con la radiación (CRR). La CRR es una enfermedad multifactorial y altamente destructiva, que compromete la función oral del paciente. El manejo de pacientes con CRR es cada vez más común en la práctica odontológica, ya que las tasas de curación de neoplasias malignas han sido mayores con los avances de la medicina. En este contexto, el presente estudio tiene como objetivo discutir los principales factores relacionados con el desarrollo de la CRR, así como las dificultades y limitaciones encontradas en su tratamiento y control. Se realizó una revisón de literatura narrativa y cualitativa, a partir de una encuesta de artículos científicos encontrados en la bases de datos Google Scholar, Pubmed y SciELO, sin restricción de año de publicación e idioma. Para ello, se utilizaron las siguientes palabras clave: Caries Dental; Dentina; Esmalte Dental; Neoplasias de la Boca; Radioterapia. Se concluye que no existe un protocolo bien definido para el tratamiento de la CRR en la literatura, y el proceso de restauración es bastante desafiante para los dentistas. Destaca la necesidad de um mejor detalle metodológico del trabajo realizado y más estudios sobre el tema con el fin de establecer un protocolo clínico eficaz, buscando, sobre todo, restaurar la salud y mejorar la calidad de vida.
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Alves, Y. B., Silva, P. C. H. Da, Carvalho, G. C., Caldas, J. P. M. & Veloso, H. H. P. (2020). Impact of radiotherapy to the head and neck region on the oral condition. Research, Society and Development, 9(10).
American Dental Association Council on Scientific Affairs. (2006) Professionally applied topical fluoride: evidence-based clinical recommendations. J Am Dent Assoc, 137(8):1151–9.
Bhandari, S., Soni, B. W., Bahl, A. & Ghoshal, S. (2020). Radiotherapy-induced oral morbidities in head and neck cancer patients. Special Care in Dentistry, 40(3), 238-250.
Brandeburski, S. B. N. & Della Bona, A. (2018). Effect of ionizing radiation on properties of restorative materials. Dental Materials, 34(2), 221-227.
Buglione, M., Cavagnini, R., Di Rosario, F., Sottocornola, L., Maddalo, M., Vassalli, L., Grisanti, S., Salgarello, S., Orlandi, E., Paganelli, C., Majorana, A., Gastaldi, G., Bossi, P., Berruti, A., Pavanato, G., Nicolai, P., Maroldi, R., Barasch, A., Russi, E. G., Raber-Durlacher, J., Murphy, B. & Magrini, S. M. (2016) Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement. Critical Reviews in Oncology/Hematology, 97, 131-142.
Cartaxo, A.C., Marinho, L. C. N., Silva, D. N. D. A., Silva, N. T. Da., Morais, M. De. L. S. De. A., Dorini, A. L. & Martins, A. R. L. De. A. (2021) Impact of radiotherapy in head and neck regions on periodontal and oral hygiene conditions. Research, Society and Development, 10 (2), e44410212745.
Cochrane, N. J., Cai, F., Huq, N. L., Burrow, M. F., Reynolds, E. C. (2010) New approaches to enhanced remineralization of tooth enamel. J Dent Res, 89:1187−1197.
Comodo, G. V., Palma, L. F., Dos Santos, M. S., Seoantes, G. A., Gonnelli, F. A. S., Segreto, R. A., Segreto, H. R. C. & Reimão, J. Q. (2020) Opportunistic oral infections in patients submitted to radiotherapy for head and neck cancer: a retrospective study. Research, Society and Development, 9 (3), e164932685.
Dashper, S. G., Shen, P., Sim, C., Liu, S. W., Butler, C. A., Mitchell, H. L., D'Cruze, T., Yuan, Y., Hoffmann, B., Walker, G. D., Catmull, D. V., Reynolds, C., & Reynolds, E. C. (2019). CPP-ACP Promotes SnF2 Efficacy in a Polymicrobial Caries Model. Journal of dental research, 98(2), 218–224.
De Felice, F., Polimeni, A., Valentini, V., Brugnoletti, O., Cassoni, A., Greco, A., de Vincentiis, M. & Tombolini, V. (2018). Radiotherapy Controversies and Prospective in Head and Neck Cancer: A Literature-Based Critical Review. Neoplasia, 20(3), 227-232.
De Moor, R. J., Stassen, I. G., van 't Veldt, Y., Torbeyns, D. & Hommez, G. M. (2011). Two-year clinical performance of glass ionomer and resin composite restorations in xerostomic head- and neck-irradiated cancer patients. Clinical Oral Investigations, 15(1), 31-8.
Dirix, P., Nuyts, S. & Bogaert, W. V. D. (2006). Radiation-Induced Xerostomia in Patients with Head and Neck Cancer: A Literature Review. Cancer, 107(11), 2525-34.
Epstein, J. B., van der Meij, E. H., Lunn, R., Stevenson-Moore, P. (1996) Effects of compliance with fluoride gel application on caries and caries risk in patients after radiation therapy for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 82:268−275.
Fonseca, J. M., Troconis, C. C., Palmier, N. R., Gomes-Silva, W., Paglioni, M. D., Araújo, A. L., Arboleda, L. P., Filho, A. J., González-Arriagada, W. A., Goes, M. F., Lopes, M. A., Brandão, T. B., Vargas, P. A., Ribeiro, A. C. & Santos-Silva, A. R. (2020). The impact of head and neck radiotherapy on the dentine-enamel junction: a systematic review. Medicina Oral Patologia Oral y Cirurgia Bucal, 25 (1) 96-105.
Galetti, R., Santos-Silva, A. R., Antunes, A. N., Alves, F. A., Lopes, A. M. & de Goes, M. F. (2014) Radiotherapy does not impair dentin adhesive properties in head and neck cancer patients. Clinical Oral Investigations, 18(7), 1171-8.
Gonçalves, L. M., Palma-Dibb, R. G., Paula-Silva, F. W., Oliveira, H. F., Nelson-Filho, P. Silva, L. A. & Queiroz, A. M. (2014). Radiation therapy alters microhardness and microstructure of enamel and dentin of permanent human teeth. Journal of Dentistry, 42(8), 986-92.
Gouvêa Vasconcellos, A. F., Palmier, N. R., Ribeiro, A., Normando, A., Morais-Faria, K., Gomes-Silva, W., Vechiato Filho, A. J., de Goes, M. F., Paes Leme, A. F., Brandão, T. B., Lopes, M. A., Marsh, P. D., & Santos-Silva, A. R. (2020). Impact of Clustering Oral Symptoms in the Pathogenesis of Radiation Caries: A Systematic Review. Caries research, 54(2), 113–126.
Gupta, N., Pal, M., Rawat, S., Grewal, M. S., Garg, H., Chauhan, D., Ahlawat, P., Tandon, S., Khurana, R., Pahuja, A. K., Mayank, M. & Devnani, B. (2015). Radiation-induced dental caries, prevention and treatment - A systematic review. National Journal of Maxillofacial Surgery, 6(2), 160-6.
INCA, Instituto Nacional de Câncer José Alencar Gomes da Silva. (2019). Estimativa 2020: incidência de câncer no Brasil. https://www.inca.gov.br/estimativa/estado-capital/brasil
Jansma, J., Vissink, A., Jongebloed, W. L., Retief, D. H. & 's-Gravenmade, E. J. (1993). Natural and induced radiation caries: A SEM study. American Journal of Dentistry, 6,130-136.
Jawad, H., Hodson, N. A. & Nixon, P. J. (2015). A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Brazilian Dental Journal, 218(2), 65-8.
Kawashita, Y., Soutome, S., Umeda, M. & Saito, T. (2020) Oral management strategies for radiotherapy of head and neck cancer. Japanese Dental Science Review, 56 (1), 62-67.
Kırca, K. & Kutlutürkan, S. (2017) Symptoms of patients with head and neck cancers undergoing radiotherapy. European Journal of Cancer Care, 26 (6).
Kielbassa, A. M., Schaller, H. G., Hellwig, E. (1998) Qualitative Befunde bei in situ erzeugter Initialkaries in tumortherapeutisch bestrahltem Dentin: eine kombiniert rasterelektronenmikroskopische und mikroradiographische Studie. Acta Med Dent Helv, 3:161–168.
Kudkuli, J., Agrawal, A., Gurjar, O. P., Sharma, S. D., Rekha, P. D., Manzoor, M. A. P., Singh, B., Rao, B. S. & Abdulla, R. (2020) Demineralization of tooth enamel following radiation therapy; An in vitro microstructure and microhardness analysis. Journal of Cancer Research and Therapeutics, 16 (3), 612-618.
Lan, X., Chan, J. Y. K., Pu, J. J., Qiao, W., Pang, S., Yang, W. F., Wong, K. C. W., Kwong, D. L. W. & Su, Y. X. (2020) Saliva electrolyte analysis and xerostomia-related quality of life in nasopharyngeal carcinoma patients following intensity-modulated radiation therapy. Radiotherapy and Oncology,150, 97-103.
Lopes, C. C. A., Rodrigues, R. B., Cenci, M. S., Uehara, J. L. S., Maske T. T., Limirio P. H. J. O., Soares, P. B. F., Novais, V. R. (2021) Effect of ionizing radiation and cariogenic biofilm challenge on root-dentin caries. Clin Oral Investig.
Lopes, C. C. A., Soares, C. J., Lara, V. C., Arana-Chavez, V. E., Soares, P. B. & Novais, V. R. (2018). Effect of fluoride application during radiotherapy on enamel demineralization. Journal of Applied Oral Science, 27.
Lou, J., Huang, P., Ma, C., Zheng, Y., Chen, J., Liang, Y., Li, H., Yin, Y., Liu, D., Yu, G. & Li, D. (2018). Parotid gland radiation dose-xerostomia relationships based on actual delivered dose for nasopharyngeal carcinoma. Journal of Applied Clinical Medical Physics, 19, 251–60.
Lu, H., Zhao, Q., Guo, J., Zeng, B., Yu, X., Yu, D. & Zhao, W. (2019) Direct radiation-induced effects on dental hard tissue. Radiation Oncology, 14 (1), 5.
Madrid, C. C., de Pauli Paglioni, M., Line, S. R., Vasconcelos, K. G., Brandão, T. B., Lopes, M. A., Santos-Silva, A. R., De Goes, M. F. (2017) Structural Analysis of Enamel in Teeth from Head-and-Neck Cancer Patients Who Underwent Radiotherapy. Caries Res, 51(2):119-128.
McComb, D., Erickson, R. L., Maxymiw, W. G. & Wood, R. E. (2002). A clinical comparison of glass ionomer, resin-modified glass ionomer and resin composite restorations in the treatment of cervical caries in xerostomic head and neck radiation patients. Operative Dentistry, 27, 430-7.
McGuire, J. D., Gorski, J. P., Dusevich, V., Wang, Y. & Walker, M. P. (2014). Type IV collagen is a novel DEJ biomarker that is reduced by radiotherapy. Journal of Dental Research, 93(10), 1028-34.
Miranda, R. R., Ribeiro, T. E., Silva, E. L. C. D., Simamoto Júnior, P. C., Soares, C. J., Novais, V. R. (2021) Effects of fractionation and ionizing radiation dose on the chemical composition and microhardness of enamel. Arch Oral Biol.
Miranda, R. R., Silva, A. C. A., Dantas, N. O., Soares, C. J. & Novais, V. R. (2019) Chemical analysis of in vivo-irradiated dentine of head and neck cancer patients by ATR-FTIR and Raman spectroscopy. Clinical Oral Investigations, 23(8), 3351-3358.
Moore, C., McLister, C., Cardwell, C., O'Neill, C., Donnelly, M. & McKenna, G. (2020) Dental caries following radiotherapy for head and neck cancer: A systematic review. Oral Oncology, 100, 104484.
Müller, V. J., Belibasakis, G. N., Bosshard, P. P., Wiedemeier, D. B., Bichsel, D., Rücker, M. & Stadlinger, B. (2019) Change of saliva composition with radiotherapy. Archives of Oral Biology, 106:104480.
Muñoz, M. A., Garín – Correa, C., González – Arriagada, W., Davila, X. Q., Häberle, P., Bedran – Russo, A., & Luque – Martínez, I. (2020) The Adverse Effects of Radiotherapy on the Structure of Dental Hard Tissues and Longevity of Dental Restoration. International Journal of Radiation Biology, 96 (7), 910 - 918.
Naves, L. Z., Novais, V. R., Armstrong, S. R., Correr-Sobrinho, L. & Soares, C. J. (2012) Effect of gamma radiation on bonding to human enamel and dentin. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 20, 2873-8.
Noone, J. & Barclay, C. (2017) Head and Neck Cancer Patients – Information for the General Dental Practitioner. Dental Update, 44 (3), 209-215.
Novais, V. R., Soares, P. B., Guimarães, C. M., Schliebe, L. R., Braga, S. S. L. & Soares, C. J. (2016). Effect of gamma radiation and endodontic treatment on mechanical properties of human and bovine root dentin. Brazilian Oral Research, 27(6), 670-4.
Palmier, N. R., Migliorati, C. A., Prado-Ribeiro, A. C., de Oliveira, M. C. Q., Vechiato Filho, A. J., de Goes, M. F., Brandão, T. B., Lopes, M. A. & Santos-Silva, A. R. (2020) Radiation-related caries: current diagnostic, prognostic, and management paradigms. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 130 (1), 52-62.
Papas, A., Russell, D., Singh, M., Kent, R., Triol, C. & Winston, A. (2008). Caries clinical trial of a remineralising toothpaste in radiation patients. Gerodontology, 25, 76-88.
Pioch, T., Golfels, D. & Staehle, H. J. (1992) An experimental study of the stability of irradiated teeth in the region of the dentinoenamel junction. Endodontics and Dental Traumatology, 8 (6), 241-4.
Powell, L. V., Persson, R. E., Kiyak, H. A. (2001) Effect of a 0.12% chlorhexidine rinse on salivary lactobacilli and mutans streptococci. J Dent Res, 80:159.
Qing, P., Huang, S., Gao, S., Qian, L. & Yu, H. (2016). Effect of gamma irradiation on the wear behavior of human tooth dentin. Clinical Oral Investigation, 20(9), 2379-86.
Reed, R., Xu, C., Liu, Y., Gorski, J. P., Wang, Y. & Walker, M. P. (2015). Radiotherapy effect on nano-mechanical properties and chemical composition of enamel and dentine. Archives of Oral Biology, 60(5), 690-7.
Rodrigues, R. B., Soares, C. J., Junior, P. C. S., Lara, V. C., Arana-Chavez, V. E. & Novais, V. R. (2018). Influence of radiotherapy on the dentin properties and bond strength. Clinical Oral Investigations, 22(2), 875-883.
Roblegg, E., Coughran, A., & Sirjani, D. (2019). Saliva: An all-rounder of our body. European journal of pharmaceutics and biopharmaceutics: official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V, 142, 133–141.
Santin, G. C., Palma-Dibb, R. G., Romano, F. L., de Oliveira, H. F., Nelson Filho, P. & de Queiroz, A. M. (2015). Physical and adhesive properties of dental enamel after radiotherapy and bonding of metal and ceramic brackets. American Journal of Orthodontics and Dentofacial Orthopedics, 148(2), 283-92.
Silva, A. R., Alves, F. A., Antunes, A., Goes, M. F., & Lopes, M. A. (2009). Patterns of demineralization and dentin reactions in radiation-related caries. Caries research, 43(1),43–49.
Soares, C. J., Castro, C. G., Neiva, N. A., Soares, P. V., Santos-Filho, P. C. F., Naves, L. Z. & Pereira, P. N. (2010). Effect of gamma irradiation on ultimate tensile strength of enamel and dentin. Journal of Dental Research, 89(2), 159-64.
Soares, C. J., Neiva, N. A., Soares, P. B., Dechichi, P., Novais, V. R., Naves, L. Z. & Marques, M. R. (2011). Effects of chlorhexidine and fluoride on irradiated enamel and dentin. Journal of Dental Research, 90,659-664.
Sroussi, H. Y., Jessri, M. & Epstein, J. (2018) Oral assessment and management of the patient with head and neck cancer. Oral and Maxillofacial Surgery Clinics of North America, 30, 445-458.
Teruel, J., Alcolea, A., Hernández, A., & Ruiz, A. J. (2015). Comparison of chemical composition of enamel and dentine in human, bovine, porcine and ovine teeth. Archives of oral biology, 60(5), 768–775.
Velo, M. M. A. C., Farha, A. L. H., da Silva Santos, P. S., Shiota, A., Sansavino, S.Z., Souza, A.T., Honório, H. M. & Wang, L. (2018). Radiotherapy alters the composition, structural and mechanical properties of root dentin in vitro. Clinical Oral Investigation, 22(8), 2871-2878.
Vissink, A., Jansma, J., Spijkervet, F. K., Burlage, F. R. & Coppes, R. P. (2003). Oral sequelae of head and neck radiotherapy. Critical Reviews in Oral Biology & Medicine, 14(3), 199-212.
Wu, V. W. C. & Leung, K. Y. (2019) A Review on the Assessment of Radiation Induced Salivary Gland Damage After Radiotherapy. Frontiers on Oncology, 9,1090.
Walker, M. P., Wichman, B., Cheng, A. L., Coster, J. & Williams, K. B. (2011). Impact of Radiotherapy Dose on Dentition Breakdown in Head and Neck Cancer Patients. Practical Radiation Oncology, 1(3), 142-148.
Yadav, S. & Yadav, H. (2013). Ionizing irradiation affects the microtensile resin dentin bond strength under simulated clinical conditions. Journal of conservative dentistry, 16, 148-151.
Yesilyurt, C., Bulucu, B., Sezen, O., Bulut, G. & Celik, D. (2008) Bond strengths of two conventional glass-ionomer cements to irradiated and non-irradiated dentin. Dental Materials Journal, 27 (5), 695-701.
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Derechos de autor 2021 Renata Borges Rodrigues; Andressa Cardoso Amorim Souza; Allyne Jorcelino Daloia de Carvalho; Camila de Carvalho Almança Lopes; Rafael Resende de Miranda; Dhiancarlo Rocha Macedo; Luiz Fernando Barbosa de Paulo; Cizelene do Carmo Faleiros Veloso Guedes; Veridiana Resende Novais
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
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