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Master's Dissertation
DOI
10.11606/D.23.2011.tde-18062011-104942
Document
Author
Full name
Priscila Fernandes Ribas
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Andre, Marcia (President)
Dias, Reinaldo Brito e
Paula, Cynthia Savioli de
Title in Portuguese
Impacto orofacial da radioterapia de cabeça e pescoço
Keywords in Portuguese
Gengiva
Radioterapia
Saúde bucal
Transtornos da articulação temporomandibular
Abstract in Portuguese
A radioterapia de cabeça e pescoço quando direcionada às glândulas salivares, articulação temporomandibular e músculos da mastigação, provoca sequelas na cavidade oral muitas vezes irreversíveis. Objetivo: Comparar a saúde oral, condição periodontal e função mandibular, antes e após a radioterapia da região de cabeça e pescoço. Métodos: Vinte e seis pacientes com diagnóstico de tumores malignos de cabeça e pescoço foram avaliados 30 dias antes, 30 e 90 dias após a radioterapia. A avaliação orofacial incluiu: avaliação dentária, periodontal e função mandibular. Também foram observadas as características gerais como tipo histológico do tumor e dose de radioterapia. Resultados: A idade média da amostra foi de 58 anos, sendo que 21 indivíduos (80,76%) eram do gênero masculino. Observamos um aumento do número de dentes cariados, entre a primeira e terceira avaliação (2,08±2,31 vs 4,19±3,41, p0,001) e um aumento do número de dentes perdidos (14±6,34 vs 14,46±6,23, p=0,006) e obturados (2,04±3,38 vs 2,73±3,54, p=0,004) a partir da segunda avaliação, provavelmente pelo preparo oral da radioterapia. Noventa dias após o término do tratamento radioterápico, observamos diminuição da inserção clínica periodontal (3,65±1,37 vs 4,10±2,08, p=0,001), pelo aumento de limite esmalte-cemento/margem gengival (1,67±1,13 vs 2,15±1,63, p=0,001). Os pacientes apresentaram prejuízo da mobilidade mandibular com diminuição de protrusão (7,88±3,59 vs 6,38±3,69, p=0,009) e da abertura bucal forçada (37,42±9,88 vs 34,12±10,51, p=0,007), além de um aumento de sinais e sintomas de disfunção temporomandibular. Conclusão: Os resultados mostram que a radioterapia provoca efeitos deletérios na região orofacial, que tendem a acentuar com o passar do tempo, ainda que o tratamento odontológico prévio seja realizado. Entretanto, o preparo de boca é relevante para minimizar os problemas decorrentes da radioterapia.
Title in English
Orofacial impact of head and neck radiotherapy
Keywords in English
Gingival
Oral health
Radiotherapy
Temporomandibular disorders
Abstract in English
When salivary glands, temporomandibular joint and muscles of mastication are in the field of radiation, radiotherapy for head and neck cancer causes sequelae in the oral cavity often irreversible. Objective: Compare oral health, periodontal condition and jaw function before and after radiotherapy of head and neck. Method: Twenty-six patients with head and neck malignant tumors were evaluated 30 days before and 30 and 90 days after radiotherapy. The orofacial evaluation included: dental, periodontal and jaw function. General characteristics as histological type of the tumor and radiotherapy´s dose were also evaluated. Results: The mean age of the sample was 58 years and 21 (80.76%) were male. We observed an increase in the number of decayed teeth, between the first and third evaluations (2.08 ± 2.31 vs. 4.19 ± 3.41, p 0.001) and an increased number of missing teeth (14 ± 6.34 vs 14.46 ± 6.23, p = 0.006) and filled (2.04 ± 3.38 vs 2.73 ± 3.54, p = 0.004) in the second assessment, probably caused by dental preparation for radiotherapy. Ninety days after the radiotherapy treatment, we observed reduction in clinical attachment (3.65 ± 1.37 vs. 4.10 ± 2.08, p = 0.001) and increased cemento-enamel / gingival margin limit (1.67 ± 1.13 vs. 2.15 ± 1.63, p = 0.001). Patients had impaired mandibular mobility in protrusion (7.88 ± 3.59 vs. 6.38 ± 3.69, p = 0.009) and forced mouth opening (37.42 ± 9.88 vs 34.12 ± 10.51, p = 0.007), and an increase in signs and symptoms of temporomandibular disorders. Conclusion: The results show that radiotherapy may have adverse effects in orofacial region and that these effects tend to worsen over time, even if orofacial treatment is realized before radiation therapy. However, orofacial pre radiotherapy treatment is relevant to minimize the problems due radiotherapy.
 
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Publishing Date
2011-06-27
 
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