Natalia Rangel Palmier1, Ana Carolina Prado Ribeiro2, Jéssica Montenegro Fonsêca1, João Victor Salvajoli3, Pablo Agustin Vargas1, Marcio Ajudarte Lopes1, Thaís Bianca Brandão4, Alan Roger Santos-Silva5. 1. Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, Piracicaba, São Paulo, Brazil. 2. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, São Paulo, Brazil. 3. Radiotherapy Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, São Paulo, Brazil. 4. Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, São Paulo, Brazil. 5. Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, Piracicaba, São Paulo, Brazil. Electronic address: alanroger@fop.unicamp.br.
Abstract
OBJECTIVE: Although radiation-related caries (RRC) are a well-known toxicity of head and neck radiotherapy, a clinical classification system for RRC has not yet been clinically validated. Therefore, the aim of this study was to assess whether the International Caries Detection and Assessment System (ICDAS) and the Post-Radiation Dental Index (PRDI) were viable methods for the assessment of RRC. STUDY DESIGN: Clinicopathologic data and intraoral digital photographs of 60 patients (833 teeth) affected by RRC were assessed and classified according to the ICDAS and PRDI criteria. RESULTS: A total of 814 (97.7%) teeth presented RRC lesions ranging from early stage to complete tooth destruction. Mean scores for the whole sample were 5 for ICDAS and 3 for PRDI, indicating that RRC were diagnosed predominately in late stages. ICDAS and PRDI criteria underestimate the clinical expressivity of RRC by not including the whole qualitative clinical spectrum of RRC, such as enamel cracks, delamination, dental crown amputation, surface color alterations, and atypical lesions topography (incisal/cuspal caries). CONCLUSIONS: ICDAS and PRDI may not be considered viable for the assessment of RRC. The development of a specific clinical classification system is urgently needed to help clinicians recognize the peculiar patterns of RRC, particularly in incipient cases.
OBJECTIVE: Although radiation-related caries (RRC) are a well-known toxicity of head and neck radiotherapy, a clinical classification system for RRC has not yet been clinically validated. Therefore, the aim of this study was to assess whether the International Caries Detection and Assessment System (ICDAS) and the Post-Radiation Dental Index (PRDI) were viable methods for the assessment of RRC. STUDY DESIGN: Clinicopathologic data and intraoral digital photographs of 60 patients (833 teeth) affected by RRC were assessed and classified according to the ICDAS and PRDI criteria. RESULTS: A total of 814 (97.7%) teeth presented RRC lesions ranging from early stage to complete tooth destruction. Mean scores for the whole sample were 5 for ICDAS and 3 for PRDI, indicating that RRC were diagnosed predominately in late stages. ICDAS and PRDI criteria underestimate the clinical expressivity of RRC by not including the whole qualitative clinical spectrum of RRC, such as enamel cracks, delamination, dental crown amputation, surface color alterations, and atypical lesions topography (incisal/cuspal caries). CONCLUSIONS: ICDAS and PRDI may not be considered viable for the assessment of RRC. The development of a specific clinical classification system is urgently needed to help clinicians recognize the peculiar patterns of RRC, particularly in incipient cases.
Authors: Mariana de Pauli Paglioni; Natalia Rangel Palmier; Ana Carolina Prado-Ribeiro; Eduardo Rodrigues Fregnani; Maria Beatriz Duarte Gavião; Thaís Bianca Brandão; Marcio Ajudarte Lopes; Ana Paula Dias Ribeiro; Cesar Augusto Migliorati; Alan Roger Santos-Silva Journal: Support Care Cancer Date: 2019-11-27 Impact factor: 3.603
Authors: Caique Mariano Pedroso; Cesar Augusto Migliorati; Joel B Epstein; Ana Carolina Prado Ribeiro; Thaís Bianca Brandão; Márcio Ajudarte Lopes; Mário Fernando de Goes; Alan Roger Santos-Silva Journal: Front Oral Health Date: 2022-07-14