Thaís Bianca Brandão1, Henrique da Graça Pinto2, Aljomar José Vechiato Filho3, Karina Morais Faria4, Maria Cecília Querido de Oliveira4, Ana Carolina Prado-Ribeiro4, Reinaldo Brito Dias5, Alan Roger Santos-Silva6, Victor Eduardo de Souza Batista7. 1. Coordinator, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 2. PhD student, Prostheses and Maxillofacial Traumatology, Dental School of the University of São Paulo (FOUSP), São Paulo, São Paulo, Brazil. 3. Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: aljomarvechiatoflo@gmail.com. 4. Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 5. Professor, Prostheses and Maxillofacial Traumatology, Dental School of the University of São Paulo (FOUSP), São Paulo, São Paulo, Brazil. 6. Assistant Professor, Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil. 7. Associate Professor, Department Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, São Paulo, Brazil.
Abstract
STATEMENT OF PROBLEM: Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness. PURPOSE: The purpose of this systematic review and meta-analysis was to determine the effectiveness of intraoral stent use and determine whether these prosthetic devices can reduce radiation dosage to nontargeted oral tissues and adverse effects related to head and neck radiation. MATERIAL AND METHODS: Two independent reviewers made a systematic search for articles published from January 2010 to March 2020 in 3 databases, supplemented by a manual search. Studies were included if they were clinical trials (randomized controlled trials, both prospective and retrospective), published in English, and evaluated radiation dose and oral adverse side effects (acute or chronic) induced by radiotherapy of participants with and without intraoral stents. RESULTS: The search strategy identified 201 studies; of which, 9 were included. A total of 251 participants were evaluated; of whom, 168 (77.3%) used intraoral stents and 57 (22.7%) were treated with radiotherapy without a prosthetic device. A statistically significant difference was found regarding the use of intraoral stents for preventing oral mucositis (P<.001), salivary changes (P=.003), and trismus (P<.02). A funnel plot showed asymmetry among the differences of means in all selected studies. CONCLUSIONS: Intraoral stents have a positive effect on preventing oral mucositis. Further clinical trials are needed to address the flaws identified in the present systematic review.
STATEMENT OF PROBLEM: Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness. PURPOSE: The purpose of this systematic review and meta-analysis was to determine the effectiveness of intraoral stent use and determine whether these prosthetic devices can reduce radiation dosage to nontargeted oral tissues and adverse effects related to head and neck radiation. MATERIAL AND METHODS: Two independent reviewers made a systematic search for articles published from January 2010 to March 2020 in 3 databases, supplemented by a manual search. Studies were included if they were clinical trials (randomized controlled trials, both prospective and retrospective), published in English, and evaluated radiation dose and oral adverse side effects (acute or chronic) induced by radiotherapy of participants with and without intraoral stents. RESULTS: The search strategy identified 201 studies; of which, 9 were included. A total of 251 participants were evaluated; of whom, 168 (77.3%) used intraoral stents and 57 (22.7%) were treated with radiotherapy without a prosthetic device. A statistically significant difference was found regarding the use of intraoral stents for preventing oral mucositis (P<.001), salivary changes (P=.003), and trismus (P<.02). A funnel plot showed asymmetry among the differences of means in all selected studies. CONCLUSIONS: Intraoral stents have a positive effect on preventing oral mucositis. Further clinical trials are needed to address the flaws identified in the present systematic review.
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