著者

曽我 麻里恵 勝良 剛詞 小林 太一 髙村 真貴 黒川 亮 新美 奏恵 田中 恵子 石山 茉佑佳 林 孝文

出版者

特定非営利活動法人 日本歯科放射線学会

雑誌

歯科放射線 (ISSN:03899705)

巻号頁・発行日

vol.61, no.2, pp.41-46, 2022 (Released:2022-04-06)

参考文献数

14

---

Background and Purpose: Dental caries that arise after radiotherapy (radiation caries) can lead to reduced masticatory function caused by tooth loss and osteoradionecrosis caused by dental infections. There are two main opinions regarding the mechanism underlying radiation caries: 1) tooth fragility caused by the direct effects of radiation and 2) a reduction in the physiological effects of saliva due to hyposalivation and a worsening of oral status. However, it has not been clarified which of these mechanisms is the main cause of radiation caries. Therefore, the purpose of this study was to investigate the risk factors for radiation caries in patients who had received head and neck radiotherapy. Material and Methods: Forty patients who had received head and neck radiotherapy were enrolled. We retrospectively investigated the relationships between radiation caries and clinical parameters, such as the treated site, irradiation field, radiation dose, and oral status, for 3 years after the completion of radiotherapy. Results: The incidence rate of radiation caries was 85%. Twenty-two percent and 78% of radiation caries occurred within and outside the irradiation field, respectively. The incidence rate of radiation caries among teeth within and outside the radiation field was 41.7% and 57.7%, respectively. The occurrence of radiation caries showed a moderate positive correlation with plaque control records. On the other hand, it was not correlated with the total radiation dose, the mean radiation dose delivered to the parotid gland, or the amount of saliva. Discussion: Our results suggested that radiation caries occur both within and outside the radiation field. It is considered that the risk of radiation caries is affected more by oral status, such as poor oral hygiene, than structural changes in teeth caused by radiation. Therefore, it is important to maintain a good oral status after head and neck radiotherapy to prevent radiation caries.

著者

新垣 理宣 勝良 剛詞 小林 大二郎 道 泰之 北本 佳住 依田 哲也 倉林 亨

出版者

特定非営利活動法人 日本歯科放射線学会

雑誌

歯科放射線 (ISSN:03899705)

巻号頁・発行日

vol.61, no.2, pp.53-57, 2022 (Released:2022-04-06)

参考文献数

14

---

Introduction: Radiation-induced dental caries is a late oral adverse event that should be considered after head and neck radiotherapy. However, there are no clinical guidelines for dental management after head and neck radiotherapy. We report a case of multiple dental caries that developed after head and neck radiotherapy in a patient in whom symptomatic treatment was challenging. Case: A 67-year-old male was referred to our department with difficulty with oral intake secondary to occlusal insufficiency. He had a history of radiotherapy for hypopharyngeal carcinoma, and nearly all of his teeth only had residual roots. We found multiple carious teeth, including in areas outside of the radiation field. We designed a temporary denture in coordination with a dental office; however, it was difficult to extract all of the patient’s teeth. The patient was followed-up; however, he died of esophageal cancer. Conclusion: Radiation-induced dental caries can even occur in teeth outside of the radiation field. In such cases, continuous preventative measures, such as oral care, are important, even before the start of radiotherapy.