Radiation dose linked to periodontitis after radiotherapy

Radiation dose can influence the development of apical periodontitis in patients undergoing radiotherapy for cancer, according to a study in Clinical Oral Investigations (January 6, 2012).

Researchers from Ghent University analyzed the effect of the radiation dose of oral radiotherapy for cancer on the presence of apical periodontitis in 36 patients without dental prescreening or specific preventive measures.

All patients had been diagnosed with cancer in the head and neck region and presented in the dental clinic following radiotherapy with side effects -- mainly radiation caries, according to the study authors. 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.

The researchers scored 628 teeth and found tooth decay in 88.2% of the 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 versus 24.9 Gy).

"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," the researchers wrote. "An increase of this prevalence 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."

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