Optical and photoacoustic study of human teeth submitted to radiotherapy

The objective was to characterize the effect of X radiation, provided by a linear accelerator, on mineralized dental tissues (enamel and dentin) aiming to understand the possible(s) mechanism(s) related(s) with the destructive collapse of the dentition that occurs after radiotherapy in patients with head and neck cancer. The effects of radiation in the forms of single and fractionated doses, were characterized by techniques Photoacoustic Absorption Spectroscopy (PAS), Raman spectroscopy (RS) and scanning electron microscopy (SEM). For the study 20 human teeth were sectioned longitudinally forming a central, lingual and vestibular portions, which were investigated in three distinct regions, namely enamel, coronal dentin and cervical dentin before and after irradiation. A group of 10 teeth was irradiated with a single dose of 70 Gy, while another group was also formed by 10 teeth was irradiated with a total dose of 70 Gy, however, divided into daily doses of 2 Gy. The central portion was characterized by PAS for physical parameter measurements of thermal diffusivity, while the vestibular portion by Raman spectroscopy for chemical analysis of the molecular constituents present. Other 18 teeth were fractured longitudinally into two parts mirror and divided into two groups of 9 teeth each. Each group had a part that served as control and the other was irradiated under the same conditions of sectioned teeth. Both sides of irradiated and control groups were analyzed by SEM in order to observe microstructural changes in the three regions defined for dental previous analysis. Using the PAS technique parameter values for the thermal diffusivity of enamel and coronal dentin and cervical before being irradiated were measured and the values are consistent with the literature. After irradiation there was significant reduction in thermal diffusivity values for both the enamel and the coronary and cervical dentin of the two groups (32% to 59%). The reduction was more pronounced for the group subjected to irradiation using fractionated dose and in special to the cervical dentin. The use of Raman spectroscopy by analyzing the intensity and position of the peaks, the spectrum associated with the inorganic phase (hydroxyapatite), proved an efficient tool for differentiation of the coronal and cervical dentin in normal teeth. The fractionated dose was more deleterious to enamel than the single dose of 70 Gy. The cervical dentin had a greater change when a single dose, p = 0.005. Finally, topographic analysis of enamel and dentin (SEM analyzed) showed no significant changes for single doses and fractionated. The chemical, physical and structural information are fundamental to understanding the behavior of dental tissues as in normal action or when treated with radiotherapy. This information is also critical in terms of elucidating and quantifying the ability of the tooth to continue holding or to create a biomimetic approach needed to connect different biomaterials used in the reconstruction of the dental tissues damaged by the action of radiation used in radiotherapy. (author)