Effect of radiation dose on the prevalence of apical periodontitis—a dosimetric analysis
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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.
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.
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.
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.
KeywordsHead and neck cancer Radiotherapy Apical periodontitis Root canal Side effects Bone inflammation
Conflict of interest
The authors declare that they have no conflict of interest.
- 5.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, 275–290Google Scholar
- 10.Sundqvist G (1976) Bacteriological studies of necrotic pulps. Umeå University Odontological Dissertation, Umeå, SwedenGoogle Scholar
- 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 2:105–116Google Scholar
- 16.Del Regato JA (1939) Dental lesions observed after roentgen therapy in cancer of the buccal cavity, pharynx and larynx. Am J Roentgenol 42:404–410Google Scholar
- 19.Ahlqwist M, Halling A, Hollender L (1986) Rotational panoramic radiography in epidemiological studies of dental health. Swedish Dent J 10:79–84Google Scholar
- 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 106–130Google Scholar