Projects / Programmes
Post-radiation caries in head and neck cancer patients: Aetiology and prevention
| Code |
Science |
Field |
Subfield |
| 3.02.00 |
Medical sciences |
Stomatology |
|
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
post-radiation caries, head and nech cancer, radiation therapy, caries prevention, caries aetiology
Researchers (12)
Organisations (2)
Abstract
Head and neck cancer Head and neck cancer (HNC) patients represent about 4% of all cancer patients and they are among the most vulnerable group of cancer patients. The treatment of the HNC is a combination of surgery, radiation therapy (RT) and chemotherapy, usually resulting in multiple and life-long side effects. RT considerably affects the environment in the oral cavity. Over 90% patients experience side effects such as dry mouth, difficulties in swallowing and speaking and have taste alterations. Post radiation caries These side effects result in the development of post-radiation caries (PRC), a rapidly advancing process that affects the teeth and ends in a complete tooth destruction if remain untreated. It affects 30-40% of HNC patients. In contrast to caries in general population, it is characterized by a rapid progression and specific lesion morphology. Prevention therapy and complications of post radiation caries Although the caries preventive measures are intensified, rampant progression is observed in 30-40% population (more than 25% of HNC patients). Carious teeth in an irradiated bone cause osteoradionecrosis (ORN) of the jaw bone Beside impaired quality of life, the costs of the ORN therapies is estimated up to 50.000 € per patient. Etiology In the past, the etiology of PRC was attributed saliva changes due to radiation injury of salivary glands. The focus was recently moved to structural changes in enamel and dentine. From the most recent studies it can be stated that radiation exposure changes the composition and structure of the tooth, , although a lot of controversies are present. Objectives 1)evaluating the impact of radiation therapy on the morphological and microstructural changes of the inorganic/organic components of enamel/dentin to increase understanding of post radiation caries, 2)evaluating the potential of calcium silicates and bioactive glasses as preventive measures for post-radiation caries prevention Description of the programme The project will concentrate on the theoretical and experimental activities around the following four themes: 1) ethical approval and patient recruitment, 2) patient treatment and tooth sample preparation, 3) evaluation of mechanical, microstructural and organic matrix changes of enamel and dentine associated with radiation therapy, 4) evaluation of calcium silicates and bioactive glasses for caries prevention. Expected results A differentiation between the enamel and dentin hardness` and the elastic modulus` values will explain possible effect of radiation and resolve the controversy about the increase/decrease of hardness values in the literature. A significant contribution to the present understanding of microstructural changes of enamel and dentine is expected. By revealing the changes in the secondary structure of the organic and inorganic matrix, i the correlation between both components, and its mutual effect will be explained. Together with microstructural changes of dentine and enamel a correlation to changes in mechanical properties is expected to be explained. Applicability of calcium silicates and bioactive glasses for remineralization potential will be evaluated and the most suitable method for the application defined. The mechanisms of mineralization are expected to be explained and the level of remineralization statistically quantified. Calcium silicate or bioactive glass formulations for treatment of post-radiation carries as well the prevention of its formation due to RT will be developed. Feasibility and clinical relevance The clinical problems, experienced during the dental treatment of HNC patients, represent a heartfelt and high motivation for proposed research. The results and conclusions of the proposed research would represent a meaningful in clinical treatment of HNC patients, relieving their problems.
