The Outcome of Primary Root Canal Treatment in Postirradiated Patients: A Case Series

Raffaella Castagnola; Irene Minciacchi; Cosimo Rupe; Luca Marigo; Nicola Maria Grande; Maria Contaldo; Adele Pesce; Carlo Lajolo

doi:10.1016/j.joen.2019.12.005

The Outcome of Primary Root Canal Treatment in Postirradiated Patients: A Case Series

J Endod. 2020 Apr;46(4):551-556. doi: 10.1016/j.joen.2019.12.005. Epub 2020 Feb 20.

Authors

Raffaella Castagnola¹, Irene Minciacchi², Cosimo Rupe³, Luca Marigo², Nicola Maria Grande², Maria Contaldo⁴, Adele Pesce⁵, Carlo Lajolo³

Affiliations

¹ Department of Operative Dentistry and Endodontics, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: raffaellacastagnola@inwind.it.
² Department of Operative Dentistry and Endodontics, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy.
³ Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy.
⁴ Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania L. Vanvitelli, Naples, Italy.
⁵ Department of Radiation Oncology, "Fondazione Policlinico Universitario A. Gemelli IRCCS," Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy.

PMID: 32088010
DOI: 10.1016/j.joen.2019.12.005

Abstract

Osteoradionecrosis (ORN) of the jaw is considered the most severe long-term adverse effect that can occur in radiation therapy patients. Teeth extractions and dental diseases are the main risk factors for ORN in irradiated patients. The aim of this case series was to evaluate the outcome of primary root canal treatments performed on patients who underwent head and neck radiotherapy and to evaluate any ORN related to the endodontic treatment. In this case series, primary root canal therapies (absence of radiolucency) were performed on 10 teeth of 8 patients who underwent radiotherapy for head and neck cancers. Radiation doses to the periapical area were calculated using the radiotherapy planning computed tomographic scan. After a 277-day mean follow-up, all patients were asymptomatic, no teeth showed periapical radiolucency, and no ORN was observed. Even if a limitation of buccal opening occurred after radiotherapy and complicated the endodontic procedures, root canal therapy seemed to be safe and a valid alternative to tooth extraction.

Keywords: Head and neck cancer; osteonecrosis; radiotherapy; root canal therapy.

MeSH terms

Dental Pulp Cavity
Head and Neck Neoplasms*
Humans
Osteoradionecrosis*
Root Canal Therapy
Tooth Extraction
Treatment Outcome