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Clinical Oral Investigations

Erschienen in:

01.12.2012 | Original Article

Effect of radiation dose on the prevalence of apical periodontitis—a dosimetric analysis

Erschienen in: Clinical Oral Investigations | Ausgabe 6/2012

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Abstract

Objectives

The objective of this study is to analyse the effect of the radiation dose of oral radiotherapy for cancer on the presence of apical periodontitis in patients without dental pre-screening or specific preventive measures.

Materials and methods

All selected patients had been diagnosed with cancer in the head and neck region and presented in the dental clinic post radiotherapy with side effects (mainly radiation caries). The panoramic radiographs of these patients were examined for several parameters, including tooth decay and apical periodontitis. The total radiation dose per tooth was determined.

Results

A total of 36 patient files were included, which accounted for 628 teeth to be scored. Tooth decay was present in 88.2% of teeth. Radiographic signs of apical periodontitis were found in 9.1% of the teeth. Teeth with apical periodontitis had significantly more caries present. The radiation dose was significantly higher for teeth with apical periodontitis (37.2 vs. 24.9 Gy). Binary logistic regression found the radiation dose to be the only explanatory variable in the presence of apical periodontitis.

Conclusions

This study found that in zones with higher radiation dose, inflammation of the jawbone due to bacterial infection of the root canal is more likely to develop. This is probably due to bone changes post radiotherapy.

Clinical relevance

An increase of this prevalance of apical periodontitis in irradiated bone found in this study needs to be taken into account in the dental evaluation before the start of radiotherapy.

Kielbassa AM, Hinkelbein W, Hellwig E, Meyer-Lückel H (2006) Radiation-related damage to dentition. Lancet Oncol 7:326–329PubMedCrossRef

Jensen SB, Pedersen AM, Vissink A, Andersen E, Brown CG, Davies AN et al (2010) A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 18:1039–1060PubMedCrossRef

Llory H, Dammron A, Gioanni M, Frank RM (1972) Some population changes in oral aerobic microorganisms, Streptococcus mutans and yeasts following irradiation of the salivary glands. Caries Res 6:298–311PubMedCrossRef

Brown LR, Dreizen S, Handler S, Johnston DA (1975) Effect of radiation-induced xerostomia on human oral microflora. J Dent 54:740–750CrossRef

Brown LR, Dreizen S, Handler S (1976) Effects of selected caries preventive regimens on microbial changes following irradiation-induced xerostomia in cancer patients. Proceedings: Microbial aspects of dental caries, Stiles, Loesche and O’Brien (eds) Sp Supp Microbiol Abstr 1, 275–290

Brown LR, Dreizen S, Daly TE, Drane JB, Handler S, Riggan LJ, Johnston DA (1978) Interrelations of oral microorganisms, immunoglobulins, and dental caries following radiotherapy. J Dent Res 57:882–893PubMedCrossRef

Rice DH, Gill G (1979) The effect of irradiation upon the bacterial flora in patients with head and neck cancer. Laryngoscope 89:1839–1841PubMedCrossRef

Keene HJ, Fleming TJ, Toth BB (1994) Cariogenic microflora in patients with Hodgkin’s disease before and after mantle field radiotherapy. Oral Surg Oral Med Oral Pathol 78:577–781PubMedCrossRef

Kakehashi S, Stanley H, Fitzgerald R (1965) The effect of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol 20:340–349PubMedCrossRef

10.

Sundqvist G (1976) Bacteriological studies of necrotic pulps. Umeå University Odontological Dissertation, Umeå, Sweden

11.

Möller AJR, Fabricius L, Dahlén G, Öhman AE, Heyden G (1981) Influence on periapical tissues of indigenous oral bacteria and necrotic pulp tissue in monkeys. Scand J Dent Res 89:475–484PubMed

12.

Kirkevang L-L, Hørsted-Bindslev P (2002) Technical aspects of treatment in relation to treatment outcome. Endod Topics 2:89–102CrossRef

13.

Hommez G, De Meerleer G, Vakaet L, De Neve W, Vermeersch H, De Moor R (2008) Prevalence of apical periodontitis and associated coronal factors in head and neck irradiated patients. Endodontic Pract Today 2:105–116

14.

Ørstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34PubMedCrossRef

15.

Vissink A, Jansma J, Spijkervet F, Burlage F, Coppes R (2003) Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med 14:199–212PubMedCrossRef

16.

Del Regato JA (1939) Dental lesions observed after roentgen therapy in cancer of the buccal cavity, pharynx and larynx. Am J Roentgenol 42:404–410

17.

Hommez GMG, Verhelst R, Vaneechoutte M, Claeys G, De Moor RJ (2008) Terminal restriction fragment length polymorphism analysis of the microflora in necrotic teeth of patients irradiated in the head and neck region. J Endod 34:1048–1051PubMedCrossRef

18.

Muhammed AH, Manson-Hing LR (1982) A comparison of panoramic and intraoral radiographic surveys evaluating a dental clinic population. Oral Surg Oral Med Oral Pathol 54:108–117PubMedCrossRef

19.

Ahlqwist M, Halling A, Hollender L (1986) Rotational panoramic radiography in epidemiological studies of dental health. Swedish Dent J 10:79–84

20.

Molander B, Ahlqwist M, Gröndahl H-G (1995) Panoramic and restrictive intraoral radiography in comprehensive oral radiographic diagnosis. Eur J Oral Sc 103:191–198CrossRef

21.

Gulsahi K, Gulsahi A, Ungor M, Genc Y (2008) Frequency of root-filled teeth and prevalence of apical periodontitis in an adult Turkish population. Int Endod J 41:78–85PubMed

22.

Sunay H, Tanalp J, Dikbas I, Bayirli G (2007) Cross-sectional evaluation of the periapical status and quality of root canal treatment in a selected population of urban Turkish adults. Int Endod J 40:139–145PubMedCrossRef

23.

Ridao-Sacie C, Segura-Egea J, Fernández-Palacín A, Bullón-Fernández P, Ríos-Santos JV (2007) Radiological assessment of periapical status using the periapical index: comparison of periapical radiography and digital panoramic radiography. Int Endod 40:433–440CrossRef

24.

Kim S (2010) Prevalence of apical periodontitis of root canal-treated teeth and retrospective evaluation of symptom-related prognostic factors in an urban South Korean population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:795–799PubMedCrossRef

25.

Gencoglu N, Pekiner FN, Gumru B, Helvacioglu D (2010) Periapical status and quality of root fillings and coronal restorations in an adult Turkisch subpopulation. Eur J Dent 4:17–22PubMed

26.

Al-Omari MA, Hazaa A, Haddad F (2011) Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:e59–e65PubMedCrossRef

27.

Peters LB, Lindeboom JA, Elst ME, Wesselinck PR (2011) Prevalence of apical periodontitis relative to endodontic treatment in an adult Dutch population: a repeated cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:523–528PubMedCrossRef

28.

Bender IB (1982) Factors influencing the radiographic appearance of bony lesions. J Endod 8:161–170PubMedCrossRef

29.

Masood F, Katz JO, Hardman PK, Glaros AG, Spencer P (2002) Comparison of panoramic radiography in the detection of simulated osteophytic lesions of the mandibular condyle. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:626–631PubMedCrossRef

30.

Pow EH, McMillan AS, Leung WK, Kwong DL, Wong MC (2003) Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem. Oral Dis 9:196–202PubMedCrossRef

31.

Rosenberg SW (1990) Chronic dental complications. NCI Monogr 9:173–178PubMed

32.

Delanian S, Lefaix J-L (2004) The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol 73:119–131PubMedCrossRef

33.

Chrcanovic BR, Reher P, Sousa AA, Harris M (2010) Osteoradionecrosis of the jaws—a current overview—part 1. Pathophysiology and risk and predisposing factors. Oral Maxillofac Surg 14:3–16PubMedCrossRef

34.

Jegoux F, Malard O, Goyenvalle E, Aguado E, Daculsi G (2010) Radiation effects on bone healing and reconstruction: interpretation of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol and Endodon 109:173–184CrossRef

35.

Kiss C (2004) Cell-to-cell interactions. Endod Top 8:88–103CrossRef

36.

Dahlén G, Haapasalo M (2008) Microbiology of apical periodontitis. In: Ørstavik D, Pitt-Ford TR (eds) Essential endodontology. Prevention and treatment of apical periodontitis, 1st edn. Blackwell Science Publications, Oxford, pp 106–130

Titel: Effect of radiation dose on the prevalence of apical periodontitis—a dosimetric analysis
Publikationsdatum: 01.12.2012
Erschienen in: Clinical Oral Investigations / Ausgabe 6/2012
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-011-0665-1

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Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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