Prevention of Caries in Cancer Patients: A Systematic Review on the Effectiveness of Dental Materials

European Journal of Prosthodontics and Restorative Dentistry (2023) 31, 224–233

Prevention of Caries in Cancer Patients: A Systematic Review on the Effectiveness of Dental Materials

Radiation Therapy Head and Neck Cancer Cancer Chemotherapy Hyposalivation

Ana B. V. Teixeira *
(DDS, MSc PhD)

Helena C. Aguiar §
Juliana D. C. Tardelli *
(DDS, MSc)

Andrea C. dos Reis *
(DDS, MSc PhD)

Address for Correspondence
Andrea C. dos Reis *
Email: andreare73@yahoo.com.br
* Department of Dental Materials and Prosthesis,
Ribeirão Preto School of Dentistry, University of
São Paulo (USP), Ribeirão Preto, Brazil.
Undergraduate student, Department of Dental
Materials and Prosthesis, Ribeirão Preto School
of Dentistry, University of São Paulo (USP),
Ribeirão Preto, Brazil

§

This study aims to identify dental materials and their effectiveness in preventing caries in patients after chemotherapy and radiotherapy for the head and neck. The electronic search was performed in PubMed, Science Direct, Embase and Scopus. All 653 articles found passed through a double-blinded screening process. The exclusion of articles by reading titles and abstracts selected 16 articles for full reading, of which 4 were included into the study. A risk of bias analysis for non-randomized and randomized articles was performed using respectively the ROBINS I and ROB II tools. The data extraction suggested that the casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), in association with fluorine, is able to form harder surfaces compared to the control group, the intraoral fluoride-releasing system (IFRS) effectiveness is similar to the fluorine in gel and a mouthwash composed of natural enzymes (Oral7) did not demonstrate effectiveness in the prevention dental caries. New randomized controlled clinical trials are necessary to evaluate the effectiveness of prevention when applying dental materials in patients after treatment of head and neck cancer.

Treatment for head and neck malignancies involves radiotherapy, chemotherapy, and surgical procedures, according to the particularities of the neoplasm.1-3 Radiotherapy and chemotherapy are associated with salivary suppression and caries increase in head and neck cancer patients, and these conditions decreased the quality of life and increased risk of infections in these patients.4-7 Thus, the search for caries preventive dental materials in patients who have undergone this type of treatment is essential and has become the research focus. Radiation decay occurs in a widespread manner, particularly in regions with little likelihood of decay, such as cervical regions of teeth and cusp tips.4,5,8 The color of the crown turns brownish and loses translucency, in addition, the teeth become friable, susceptible to wear, and enamel delamination occurs.4,5,8,9 Caries caused by chemotherapy drugs that suppress salivary glands have lower scientific evidence and, unlike radiation caries, do not have specific clinical characteristics.10-12 The degeneration of salivary gland cells is one of the consequences of salivary gland-suppressing radiotherapies and chemotherapy drugs.6,11,13,14 Decreased salivation favors the occurrence and evolution of dental caries due to the lack of components that stimulates proper maintenance of the dental

Received: 30.05.2022 Accepted: 17.01.2023

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