Radiographic Assessment of Pulp Stone Prevalence in Patients Undergoing Head and Neck Radiotherapy

Year 2024, Volume: 13 Issue: 3, 490 - 495, 24.09.2024

Fatma Tunç , Kemal Yılan

https://doi.org/10.54617/adoklinikbilimler.1501702

Abstract

ABSTRACT
Aim: To evaluate the prevalence of pulp stones in patients undergoing head and neck radiotherapy in comparison to healthy subjects.
Materials and Methods: Patient records retrieved from the XXXXXX University Dentistry Faculty between the years 2014 and 2022 were selected. Panoramic images of oncologic patients exposed to head and neck radiation, as well as healthy subjects, were included in the study. Radiographies of patients with complicated systemic conditions, edentulous patients, and patients with full-mouth fixed bridges were excluded. The groups were arranged as equivalent to each other in terms of age and gender. The presence of pulp stones in the first and second molar teeth of 124 (Group Radiotherapy (n=62) and Group Control (n=62)) patients was radiographically assessed by two observers. The Chi-square test was employed for statistical analysis of the data.
Results: The ratio of pulp stones was found to be significantly higher in the radiotherapy group (50%) (31) as compared to the control group (19.5%) (12) (p<0.05).
Conclusion: Pulp stones are more common in patients exposed to head and neck radiotherapy. Ionized radiation therapy may have induced calcification in the pulp space.

Keywords

Head and neck cancer, Panoramic radiograph, Pulp calcification

Baş ve Boyun Radyoterapisi Uygulanan Hastalarda Pulpa Taşı Prevalansının Radyografik Olarak İncelenmesi

Abstract

ÖZET
Amaç: Baş-boyun radyoterapisi uygulanan hastalarda pulpa taşı prevalansını sağlıklı bireylerle karşılaştırmalı olarak değerlendirmek.
Gereç ve Yöntem: XXXXXX Üniversitesi Diş Hekimliği Fakültesi'nden 2014-2022 yılları arasında alınan hasta kayıtları seçildi. Çalışmaya baş ve boyun radyasyonuna maruz kalan onkolojik hastaların yanı sıra sağlıklı bireylerin panoramik görüntüleri de dahil edildi. Sistemik rahatsızlıkları olan hastaların, dişsiz hastaların ve tam ağız sabit köprülü hastaların radyografileri çalışma dışı bırakıldı. Gruplar yaş ve cinsiyet açısından birbirine denk olacak şekilde düzenlendi. 124 (Grup Radyoterapi (n=62) ve Grup Kontrol (n=62)) hastanın birinci ve ikinci büyük azı dişlerindeki pulpa taşlarının varlığı iki gözlemci tarafından radyografik olarak değerlendirildi. Verilerin istatistiksel analizinde ki-kare testi kullanıldı.
Bulgular: Pulpa taşı oranı radyoterapi grubunda (%50) (%31) kontrol grubuna (%19,5) (12) göre anlamlı olarak yüksek bulundu (p<0,05).
Sonuç: Pulpa taşları baş boyun radyoterapisine maruz kalan hastalarda daha sık görülmektedir. İyonize radyasyon tedavisi pulpa boşluğunda kalsifikasyona neden olmuş olabilir.

Keywords

Baş ve boyun kanser;, Panoramik radyograf;, Pulpa kalsifikasyonu

References

• Gulsahi A, Cebeci AI, Ozden S. A radiographic assessment of the prevalence of pulp stones in a group of Turkish dental patients. Int Endod J 2009;42:735–9.
• Çolak H, Çelebi AA, Hamidi MM, et al. Assessment of the prevalence of pulp stones in a sample of Turkish Central Anatolian population. World J 2012;2012:804278.
• Goga R, Chandler NP, Oginni AO. Pulp stones: a review. Int Endod J 2008;41:457–68.
• Baghdady VS, Ghose LJ, Nahoom HY. Prevalence of pulp stones in a teenage Iraqi group. J Endod 1988;14:309¬-11.
• Siskos GJ, Georgopoulou M. Unusual case of general pulp calcification (pulp stones) in a young Greek girl. Endod Dent Traumatol 1990;6:282–4.
• Pashley DH, Walton RE, Slavkin HC. Histology and physiology of the dental pulp. In: JI Ingle, LK Bakland, eds. Endodontics, 5th edn. Hamilton, ON, Canada: BC Decker Inc; 2002. pp. 43–5.
• annati R, Afshari M, Moosazadeh M, et al. Prevalence of pulp stones: A systematic review and meta-analysis. J Evid Based Med 2019;12:133-9.
• Yeluri G, Kumar CA, Raghav N. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography. Contemp Clin Dent 2015;6:147-51.
• Gabardo MCL, Wambier LM, Rocha JS, et al. Association between Pulp Stones and Kidney Stones: A Systematic Review and Meta-analysis. J Endod 2019;45:1099-105.
• Ezoddini-Ardakani F, Namayandeh SM, Sadr-Bafghi SM, et al. Association of pulp stones with coronary artery stenosis. Community Dent Health 2011;28:305–7.
• Srivastava KC, Shrivastava D, Nagarajappa AK, et al. Assessing the prevalence and association of pulp stones with cardiovascular diseases and diabetes mellitus in the saudi arabian population—a cbct based study. Int J Environ Res Public Health 2020;17:9293.
• Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin 2021;71:7– 33.
• Weissheimer T, So BB, Pradebon MC, et al. Head and neck radiotherapy effects on the dental pulp vitality and response to sensitivity tests: A systematic review with meta‐analysis. Int Endod J 2022;55:563-78.
• Ranjitkar S, Taylor JA, Townsend GC. A radiographic assessment of the prevalence of pulp stones in Australians. Aust Dent J 2002;47:36–40.
• Vissink A, Burlage FR, Spijkervet FKL, et al. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 2003;14:213-25.
• Kawashita Y, Soutome S, Umeda M, et al. Oral management strategies for radiotherapy of head and neck cancer. Jpn Dent Sci Rev 2020;56:62-7.
• Garg H, Grewal MS, Rawat S, et al. Dental pulp status of posterior teeth in patients with oral and oropharyngeal cancer treated with concurrent chemoradiotherapy. J Endod 2015;41:1830–3.
• Gupta N, Grewal MS, Gairola M, et al. Dental pulp status of posterior teeth in patients with oral and oropharyngeal cancer treated with radiotherapy: 1- year follow- up. J Endod 2018;44:549– 54.
• Knowles JC, Chalian VA, Shidnia H. Pulp innervation after radiation therapy. J Prosthet Dent 1986;56:708–11.
• Madani Z, Azarakhsh S, Shakib P, et al. Histopathological changes in dental pulp of rats following radiotherapy. Dent Res J 2017;14:19–24.
• Ribeiro TE, Novais VR, Estrela C, et al. Does radiotherapy treatment alter the pulp condition in patients with head and neck cancer? A systematic review. Braz Oral Res 2023;37: e079.
• Sodek J, Chen J, Nagata T, et al. Regulation of osteopontin expression in osteoblasts. Ann N Y Acad Sci 1995;760:223–41.
• Hirota S, Imakita M, Kohri K, et al. Expression of osteopontin messenger RNA by macrophages in atherosclerotic plaques. A possible association with calcification. Am J Pathol 1993;143:1003-¬8.
• Kohri K, Nomura S, Kitamura Y, et al. Structure and expression of the mRNA encoding urinary stone protein (osteopontin). J Biol Chem 1993;268:15180–84.
• Hirota S, Ito A, Nagoshi J, et al. Expression of bone matrix protein messenger ribonucleic acids in human breast cancers. Possible involvement of osteopontin in development of calcifying foci. Lab Invest 1995;72:64–9.
• Havelek R, Soukup T, Cmielova J, et al. Ionizing radiation induces senescence and differentiation of human dental pulp stem cells. Folia Biol 2013;59:188-97.
• James VE, Schour I, Spence JM. Biology of the pulp and its defence. Journal of the American Dental Association 1959;5:903–11.
• Silva ARS, Alves FA, Antunes A, et al. Patterns of Demineralization and Dentin Reactions in Radiation-Related Caries. Caries Res 2009;43:43-9.
• Hong CH, Nape-as JJ, Hodgson BD, et al. A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer 2010;18:1007-21.
• Ciftcioglu N, Ciftcioglu V, Vali H, et al. Sedimentary rocks in our mouth: dental pulp stones made by nanobacteria. In Instruments, Methods, and Missions for Astrobiology 1998;3441:130-6.