O tratamento radioterápico altera a condição pulpar de dentes de pacientes com câncer de cabeça e pescoço? Uma revisão sistemática

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Universidade Federal de Goiás


Objective: This study aims to identify possible changes in pulp behavior during radiotherapy and follow-up periods in patients with head and neck cancer. Purpose: The main purpose of this study was to answer the question: “Radiotherapy can cause changes in the pulp condition of teeth of irradiated patients in the head and neck region during treatment?”. Material and Method: Clinical Observational Studies in adults with Head and Neck Cancer undergoing treatment with ionizing radiation, with longitudinal or cross-sectional follow-up to measure SpO2 and/or pulp sensitivity to cold stimulation, were determined as eligible studies. Literature Review, Case Reports, Abstracts, Opinion Articles, Letters to the Editor, and studies with in vitro methodology were excluded. A systematic literature search was carried out in six different databases until September 2021, including the “grey literature” and the search in the references of the selected studies. Two independent evaluators selected the studies, extracted the data and recorded them in electronic spreadsheets, and evaluated the methodological quality using the JBI tool, Checklist for Quasi-Experimental Studies. Data were qualitatively assessed using the Synthesis Without Metaanalysis (SWiM) guidelines. Results: After removing duplicate articles and careful analysis of title, abstracts, and full reading of the papers, seven studies were included; of these, four were carried out in Brazil and three in India, with participants from both genders. Of the studies evaluated, four used the Cold Sensitivity Test, followed by two that associated Pulse Oximetry and Cold Sensitivity, and one evaluated only the Pulse Oximetry. The evaluation in the initial periods to radiotherapy, both with the Cold Sensitivity Test and Pulse Oximetry, showed a decrease in the sensitive response and in the levels of SpO2, with a maximum period of 1 year. However, for later analyses, from 5 to 6 years after the end of radiotherapy treatment, there was normalization of the responses of both tests. Most studies presented Methodological Quality as High. Also, most studies do not detail the type of ionizing radiation used in the article, and implications for the studies' clarity can be considered a limitation. Conclusion: It can be concluded that radiotherapy causes changes in pulp behavior patterns in the short term; however, there is recovery and return to average values after long periods. This Systematic Review followed the 2020 PRISMA guidelines, and its9 protocol was registered on the PROSPERO platform before it began with the number CRD42021276338.



RIBEIRO, T. E. O tratamento radioterápico altera a condição pulpar de dentes de pacientes com câncer de cabeça e pescoço? Uma revisão sistemática. 2022. 41 f. Dissertação (Mestrado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2022.