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. 2021 Jun 9;26(3):389-399.
doi: 10.5603/RPOR.a2021.0046. eCollection 2021.

Conformational and constitutional analysis of dental caries following radiotherapy for head and neck cancer

Joslei Carlos Bohn  1 , Cassiano Lima Chaiben  2 , Suzana Soares de Souza  3 , Anelize Manuela Bahniuk Rumbelsperger  4 , Ângela Fernandes  1 , Maria Ângela Naval Machado  1 , Thiago Gomes da Silva  4 , Antonio Adilson Soares de Lima  1
Affiliations

Conformational and constitutional analysis of dental caries following radiotherapy for head and neck cancer

Joslei Carlos Bohn et al. Rep Pract Oncol Radiother. .

Abstract

Background: This study aimed to investigate the morphology and chemical composition of dental caries related to ionizing radiation (DCIR), an aggressive and progressive disease that affects dental hard tissues.

Materials and methods: Eight human teeth with DCIR were paired with sixteen control teeth (8 teeth with conventional caries and 8 without caries) and included in this study. An analysis of the morphology of the lesions was performed using the following techniques: periapical radiography, cone beam computed tomography, computed microtomography, and scanning electron microscopy. The chemical composition was assessed using X-ray dispersive spectroscopy.

Results: There was more demineralization in DCIR lesions when compared to conventional dental caries, even though there was no cavitation in the cervical region of the teeth. The superficial roughness and topography of DCIR lesions were similar to those of healthy teeth. On the other hand, lesions of conventional dental caries showed greater surface and topographic irregularity when compared to DCIR and healthy teeth (p = 0.001). Calcium (Ca) and phosphorus (P) levels were lower in DCIR lesions when compared to controls. However, higher levels of carbon (C) have been observed in DCIR lesions. There was a greater loss of the mineral matrix in DCIR followed by conventional caries. The reduction in the mineral matrix (Ca and P) was compatible with the imaging patterns observed in teeth with DCIR and conventional caries.

Conclusion: Despite their rapid evolution, DCIR presents an irregular, apparently intact surface with significant changes in the amount of Ca, P, and C.

Keywords: computed microtomography; computed tomography; dental caries; electron microscopy; radiotherapy; spectroscopy.

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Conflict of interest statement

Conflict of interests None declared.

Figures

Figure 1
Figure 1
Clinical and imaginological images of teeth with dental caries related to ionizing radiation (DCIR), conventional carie and healthy. Columns 1 and 2: Clinical. Columns 3 and 4: radiographic images. Columns 5 and 6: tomographic images. Columns 7–10: images by micro CT scanning; GDCIR — eight teeth with caries related to ionizing radiation; GCC — eight teeth with conventional caries; GHT — eight healthy teeth
Figure 2
Figure 2
SEM photomicrographs of dental surface. A, B, C, D: Teeth with dental caries related to ionizing radiation (DCIR); E, F, G, H: Teeth with conventional caries; I, J, K, L: Healthy teeth; A, E, I: at 50x magnification; B, F, J: at 500x magnification; C, G, K: at 5,000x magnification; D, H, L: at 25,000x magnification; the rectangles refer to the area selected for the next magnification. GDCIR — eight teeth with caries related to ionizing radiation; GCC — eight teeth with conventional caries; GHT — eight healthy teeth
Figure 3
Figure 3
SEM photomicrographs of dental surface. Images in the upper region — topography. Images in the lower region — surface roughness
Figure 4
Figure 4
Three-dimensional projection of superficial topography by SEM. A. Tooth with caries related to ionizing radiation. B. Tooth with conventional caries. C. Healthy tooth
See this image and copyright information in PMC

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