Late Effects of Head and Neck Radiotherapy on Pulp Vitality Assessed by Pulse Oximetry

J Endod. 2016 Jun;42(6):886-9. doi: 10.1016/j.joen.2016.02.016. Epub 2016 Apr 9.

Abstract

Introduction: Radiation therapy (RT) of malignant tumors in the head and neck area may have damaging effects on surrounding tissues. The aim of this investigation was to evaluate the long-term effects of ionizing radiation on pulp vitality by measuring pulp oxygenation levels (%SpO2) in patients with history of RT of intraoral and oropharyngeal tumors 4-6 years after treatment.

Methods: In an experimental group RT (n = 90, history of RT) and a control group CON (n = 90, no history of RT), pulp vitality was assessed by measuring %SpO2 by using pulse oximetry and pulp sensitivity by cold thermal testing. All anterior teeth without history of endodontic therapy of the participants in group RT were measured (n = 693), regardless of the quadrant and the irradiated area. An equal number of anterior teeth were tested in group CON.

Results: There was no significant difference between the %SpO2 levels in group RT (92.7%; standard deviation, ± 1.83) and group CON (92.6%; standard deviation, ± 1.80). All teeth in RT and CON groups showed a positive response to the thermal test. All tested teeth were considered vital.

Conclusions: Pulp %SpO2 was found to be within normal limits 4-6 years after RT. This suggests that RT may not have a long-term influence on pulp vitality, and reported short-term changes in pulpal microcirculation because of RT may be temporary.

Keywords: Blood flow; cancer; dental pulp; microcirculation; pulse oximetry; radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Dental Pulp / blood supply
  • Dental Pulp / radiation effects*
  • Dental Pulp Test / methods*
  • Female
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Incisor / radiation effects
  • Male
  • Microcirculation / radiation effects
  • Middle Aged
  • Oropharyngeal Neoplasms / radiotherapy
  • Oximetry / methods*
  • Oxygen / analysis
  • Oxygen / blood
  • Radiation, Ionizing
  • Radiotherapy / adverse effects*
  • Regional Blood Flow / radiation effects

Substances

  • Oxygen