The impact of radiotherapy on pulp vitality in patients with head and neck cancer: A systematic review

Abstract

Introduction: Root canal treatment is considered an ideal treatment option instead of dental extraction to prevent the development of osteoradionecrosis in head and neck cancer (HNC) patients postradiotherapy (RT). This systematic review aimed to assess the impact of RT on pulp vitality in HNC patients. Materials and Methods: The databases of MEDLINE and EMBASE were searched from 1946 up to February 2019 for pulp vitality of the teeth of HNC patients (>16 years old) post-RT. Two authors independently completed the review's stages. The results were summarized narratively. The Joanna Briggs Institute critical appraisal tools were used to assess quality of included papers. Results: 1153 studies were identified and only 2 studies were included in data synthesis. In the two studies, the case and control groups were almost similar according to the source of a similar cohort. Both studies identified confounding variables clearly, but they did not explain strategies used to deal with confounding variables. Conclusions: Pulp vitality might be affected with high doses of RT during treatment (>35 Gy) and at the end of treatment course (60–70 Gy).

Keywords

• head and neck cancer
• osteoradionecrosis
• pulp oxygen saturation
• pulp vitality
• radiotherapy