The impact of head and neck radiotherapy on the dentine-enamel junction.: A systematic review

J-M Fonseca; C-C Troconis; N-R Palmier; W Gomes-Silva; M-D Paglioni; A-L Araújo; L-P Arboleda; A-J Filho; W-A González-Arriagada; M-F Goes; M-A Lopes; T-B Brandão; P-A Vargas; A-C Ribeiro; A-R Santos-Silva

doi:10.4317/medoral.23212

The impact of head and neck radiotherapy on the dentine-enamel junction. A systematic review

J-M Fonseca, C-C Troconis, N-R Palmier, W Gomes-Silva, M-D Paglioni, A-L Araújo, L-P Arboleda, A-J Filho, W-A González-Arriagada, M-F Goes, M-A Lopes, T-B Brandão, P-A Vargas, A-C Ribeiro, A-R Santos-Silva^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

BACKGROUND: Radiotherapy is widely used in contemporary head and neck cancer treatment protocols. The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic destruction to the teeth is one of the most controversial topics in the field of oral oncology. Therefore, this systematic review aimed to investigate ionising radiation as an independent factor for physical and chemical changes on the dentine-enamel junction (DEJ), a pivotal dental topography for the onset and progression of radiation-related caries (RRC) and enamel delamination.

MATERIAL AND METHODS: Systematic searches were conducted on three databases: Scopus, MEDLINE (Via PubMed) and Embase (Elsevier). Laboratory studies evaluating the effects of simulated or in vivo HNRT on the DEJ were included. The GRADE tool adapted for in vitro studies was used to assess the methodological quality.

RESULTS: Of the 154 initially selected studies, eight met the inclusion criteria, from which five studies were graded as high quality of evidence, two studies were graded as moderate quality and one as low quality. Two studies did not demonstrate DEJ alterations following HNRT while the other six articles described several organic and inorganic changes in the DEJ of irradiated teeth samples. These radiogenic events were mostly detected through micro and nanoindentation, Raman micro-spectroscopy, confocal microscopy, Western blotting and optical coherence tomography.

CONCLUSIONS: HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination.

Original language	English
Pages (from-to)	e96-e105
Number of pages	10
Journal	Medicina Oral, Patologia Oral y Cirugia Bucal
Volume	25
Issue number	1
DOIs	https://doi.org/10.4317/medoral.23212
State	Published - 1 Jan 2020
Externally published	Yes

Keywords

Dental Caries
Dental Enamel
Dentin
Head and Neck Neoplasms
Humans
Tooth

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.4317/medoral.23212

Cite this

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 Cirugia Bucal, 25(1), e96-e105. https://doi.org/10.4317/medoral.23212

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title = "The impact of head and neck radiotherapy on the dentine-enamel junction.: A systematic review",

abstract = "BACKGROUND: Radiotherapy is widely used in contemporary head and neck cancer treatment protocols. The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic destruction to the teeth is one of the most controversial topics in the field of oral oncology. Therefore, this systematic review aimed to investigate ionising radiation as an independent factor for physical and chemical changes on the dentine-enamel junction (DEJ), a pivotal dental topography for the onset and progression of radiation-related caries (RRC) and enamel delamination.MATERIAL AND METHODS: Systematic searches were conducted on three databases: Scopus, MEDLINE (Via PubMed) and Embase (Elsevier). Laboratory studies evaluating the effects of simulated or in vivo HNRT on the DEJ were included. The GRADE tool adapted for in vitro studies was used to assess the methodological quality.RESULTS: Of the 154 initially selected studies, eight met the inclusion criteria, from which five studies were graded as high quality of evidence, two studies were graded as moderate quality and one as low quality. Two studies did not demonstrate DEJ alterations following HNRT while the other six articles described several organic and inorganic changes in the DEJ of irradiated teeth samples. These radiogenic events were mostly detected through micro and nanoindentation, Raman micro-spectroscopy, confocal microscopy, Western blotting and optical coherence tomography.CONCLUSIONS: HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination.",

keywords = "Dental Caries, Dental Enamel, Dentin, Head and Neck Neoplasms, Humans, Tooth",

author = "J-M Fonseca and C-C Troconis and N-R Palmier and W Gomes-Silva and M-D Paglioni and A-L Ara{\'u}jo and L-P Arboleda and A-J Filho and W-A Gonz{\'a}lez-Arriagada and M-F Goes and M-A Lopes and T-B Brand{\~a}o and P-A Vargas and A-C Ribeiro and A-R Santos-Silva",

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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 Cirugia Bucal, vol. 25, no. 1, pp. e96-e105. https://doi.org/10.4317/medoral.23212

TY - JOUR

T1 - The impact of head and neck radiotherapy on the dentine-enamel junction.

T2 - A systematic review

AU - Fonseca, J-M

AU - Troconis, C-C

AU - Palmier, N-R

AU - Gomes-Silva, W

AU - Paglioni, M-D

AU - Araújo, A-L

AU - Arboleda, L-P

AU - Filho, A-J

AU - González-Arriagada, W-A

AU - Goes, M-F

AU - Lopes, M-A

AU - Brandão, T-B

AU - Vargas, P-A

AU - Ribeiro, A-C

AU - Santos-Silva, A-R

PY - 2020/1/1

Y1 - 2020/1/1

N2 - BACKGROUND: Radiotherapy is widely used in contemporary head and neck cancer treatment protocols. The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic destruction to the teeth is one of the most controversial topics in the field of oral oncology. Therefore, this systematic review aimed to investigate ionising radiation as an independent factor for physical and chemical changes on the dentine-enamel junction (DEJ), a pivotal dental topography for the onset and progression of radiation-related caries (RRC) and enamel delamination.MATERIAL AND METHODS: Systematic searches were conducted on three databases: Scopus, MEDLINE (Via PubMed) and Embase (Elsevier). Laboratory studies evaluating the effects of simulated or in vivo HNRT on the DEJ were included. The GRADE tool adapted for in vitro studies was used to assess the methodological quality.RESULTS: Of the 154 initially selected studies, eight met the inclusion criteria, from which five studies were graded as high quality of evidence, two studies were graded as moderate quality and one as low quality. Two studies did not demonstrate DEJ alterations following HNRT while the other six articles described several organic and inorganic changes in the DEJ of irradiated teeth samples. These radiogenic events were mostly detected through micro and nanoindentation, Raman micro-spectroscopy, confocal microscopy, Western blotting and optical coherence tomography.CONCLUSIONS: HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination.

AB - BACKGROUND: Radiotherapy is widely used in contemporary head and neck cancer treatment protocols. The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic destruction to the teeth is one of the most controversial topics in the field of oral oncology. Therefore, this systematic review aimed to investigate ionising radiation as an independent factor for physical and chemical changes on the dentine-enamel junction (DEJ), a pivotal dental topography for the onset and progression of radiation-related caries (RRC) and enamel delamination.MATERIAL AND METHODS: Systematic searches were conducted on three databases: Scopus, MEDLINE (Via PubMed) and Embase (Elsevier). Laboratory studies evaluating the effects of simulated or in vivo HNRT on the DEJ were included. The GRADE tool adapted for in vitro studies was used to assess the methodological quality.RESULTS: Of the 154 initially selected studies, eight met the inclusion criteria, from which five studies were graded as high quality of evidence, two studies were graded as moderate quality and one as low quality. Two studies did not demonstrate DEJ alterations following HNRT while the other six articles described several organic and inorganic changes in the DEJ of irradiated teeth samples. These radiogenic events were mostly detected through micro and nanoindentation, Raman micro-spectroscopy, confocal microscopy, Western blotting and optical coherence tomography.CONCLUSIONS: HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination.

KW - Dental Caries

KW - Dental Enamel

KW - Dentin

KW - Head and Neck Neoplasms

KW - Humans

KW - Tooth

U2 - 10.4317/medoral.23212

DO - 10.4317/medoral.23212

M3 - Article

C2 - 31880287

SN - 1698-4447

VL - 25

SP - e96-e105

JO - Medicina Oral, Patologia Oral y Cirugia Bucal

JF - Medicina Oral, Patologia Oral y Cirugia Bucal

IS - 1