Reparo da Periodontite Apical pós-tratamento endodôntico em pacientes irradiados na região de cabeça e pescoço: um estudo de caso-controle

Abstract

Head and neck cancer is a malignant neoplasm, the occurrence of which is related to alcohol and tobacco consumption. Radiotherapy is one of the main approaches for its treatment; however, it can cause side effects on the oral mucosa, masticatory muscles, salivary glands, and teeth. The objective of this study was to evaluate the repair of apical periodontitis in endodontically treated teeth in individuals with head and neck cancer treated with radiotherapy, through a. This is an analytical matched case-control study, carried out based on the approval of the Research Ethics Committee on Human Beings through opinion 2.190.651 / CAAE: 68689017.6.0000.0053; complying with the norms of Resolution 466/12. Patients irradiated in the head and neck region comprised the case group; and normally active adult patients comprised the control group, matched by sex and age. Periapical radiographs were performed using the bisecting angle technique, with the aid of a digital sensor and X-ray equipment, to verify the repair of the previously established pathology. The Mann-Whitney test and the chi-square test were used for statistical analysis, with 95% confidence intervals to measure the precision of the results. The epidemiological profile of patients with Head and Neck Cancer showed a predominance of females, with a median age of 50.0 years, most of whom reported being alcohol and/or tobacco users. The most affected anatomical regions were the pharynx and oral cavity. It was also observed that 80% of the patients in the case group had repair of the endodontic pathology, while only 20% persisted with no regression of the lesion; in the control group, 95% of the evaluated cases had repair. Therefore, there was no statistically significant difference (p=0.251) in the repair of apical periodontitis in patients with head and neck cancer when compared to normo-reactive patients from the adult population. It is concluded that apical periodontitis repair was observed, with bone healing possible even in the face of reduced cell numbers and low oxygen concentration. These cells, even in smaller quantities, were viable for attenuating the inflammatory process associated with residual periapical infection.