Patterns of Demineralization and Dentin Reactions in Radiation-Related Caries

Caries Research - Tập 43 Số 1 - Trang 43-49 - 2009
Alan Roger Santos‐Silva1, Fábio Abreu Alves2, Alberto Nogueira da Gama Antunes1, M F De Goes1, Márcio Ajudarte Lopes1
1Universidade Estadual de Campinas
2Stomatology

Tóm tắt

Radiation-related caries is a unique form of rampant decay and is a complication of head and neck radiotherapy that frequently causes generalized dental destruction and impairs quality of life in cancer patients. The aim of this study was to investigate the patterns of demineralization of caries in irradiated patients and to establish whether direct radiogenic damage to the dentition might be important in the progression of radiation-related caries. Teeth from patients who had concluded radiotherapy were examined histologically by polarized light microscopy, and the ultrastructure was examined by scanning backscattered electron microscopy. Cervical caries and incisal caries, a very unusual sort of lesion, were widely detected. Additionally, diffuse brown discoloration of the smooth surface of enamel was frequently observed. Polarized light microscopy suggested that these areas were incipient caries. Evidence of normal odontoblast function was observed in the detection of reactionary dentin and intratubular dentin deposition. In conclusion, radiation-related caries seems to have the same morphological and demineralization pattern as ordinary caries, with the presence of demineralized dentin, a translucent zone, dentin dead tracts, reactionary dentin and intratubular dentin deposition. Based on these findings, direct radiogenic destruction of the teeth seems to be not essential to the microscopic progression of radiation-related caries.

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