THE EFFECT OF ORAL SYMPTOMS CLUSTER IN THE PATHOGENESIS OF RADIATION-RELATED CARIES

Abstract

Objective To present a narrative review of the relevance and effect of oral cluster in the pathogenesis of RRC. Study Design A narrative review of the literature was conducted, evidencing the effect of of oral in radiation-related caries (RRC) development. Results The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic damage to dentition and lead to RRC is a highly controversial topic. Publications based on in vitro studies described a series of radiogenic events, such as increased enamel dissolution, metalloproteinases activation, dentin enzymatic destruction, dentin-enamel junction instability, and pulp hypovascularization. However, there is increasing evidence that symptom clusters may have a pivotal role in several HNRT toxicities. The so-called clustering of oral symptoms has been previously described and is composed by concurrent mucositis, taste changes, oral infections, oral pain, trismus, hyposalivation, altered saliva composition, and oral microbiota shift, leading to significant dietary changes, deficient oral hygiene, and a highly cariogenic oral environment, which may work in synergy to affect the risk for RRC development and progression. Conclusions Clustering of oral complications should be considered in the context of the patients submitted to head and neck radiotherapy. Financial support: CAPES PNPD-UNICAMP.