RELAÇÃO DA RADIOTERAPIA DE CÂNCER DE CABEÇA E PESCOÇO COM A POLPA DENTAL: uma revisão de literatura

Abstract

Root canal treatment is considered an ideal treatment option instead of tooth extraction to prevent the development of osteoradionecrosis in post-radiotherapy (RT) head and neck cancer (HNC) patients. This literature review aimed to investigate the main changes left in the oral region by radiotherapy in pulp vitality in patients with PCC, emphasizing endodontic treatment and how the dental pulp reacts. The methodology used was a descriptive literature review. The databases used were PubMed/MedLine, SciELO, LILACS from 2010 to 2022. The descriptors used in the search were: pulp vitality, radiotherapy and endodontics (radiotherapy and endodontics), dental pulp and radiotherapy (dental pulp and radiotherapy). The results were summarized narratively. Within this criterion, 39 articles were found, 33 articles were used, which were included in the data synthesis. In studies, this review showed that radiotherapy for PCC brings about significant changes in dental pulp responses, but does not appear to cause pulp necrosis. Significant limitations regarding the control of confounding factors, classification of measures and outcome interventions were verified, reinforcing the need for well-designed studies. It is concluded that pulp vitality can be affected with high doses of RT during treatment (>35 Gy) and at the end of treatment (60-70 Gy). This literature review also demonstrated that radiation therapy for PCC induced significant changes in pulpal response with moderate quality of evidence. Such altered responses cannot accurately determine pulp status.