Condição periodontal de indivíduos submetidos à radioterapia associada ou não à quimioterapia das vias aerodigestivas superiores: um estudo prospectivo

Abstract

Studies have investigated the progression of periodontal disease in patients undergoing radiotherapy, as part of the treatment of malignant tumors of the upper airways (mainly in tumors of the mouth). They showed increased periodontal attachment loss, which can be explained by a combination of factors as the direct action of radiation on tissues, accumulation of bacterial biofilm and by altering the host immune response. Unfortunately, these studies are few and small sample size. The aim of this longitudinal study was to evaluate the onset and progression of periodontal disease in patients with malignant tumors of the upper airway tract treated with radiotherapy with or without chemotherapy. The study included 53 patients, of whom 28 were followed until the end of time proposed for the study. Patients were allocated into two groups according to the periodontal diagnosis: Healthy and Gingivitis Group (GHG) and Periodontitis Group (PG). Bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and the plaque index (PI) were recorded at the baseline (before cancer treatment), up to 10 days and 180 days after finishing radiotherapy. Descriptive measures of PI and periodontal parameters were reported in absolute frequency, relative and average values and percentages when appropriate. Tests to assess the normality and homogeneity of the parametric data were performed. The changes in periodontal parameters along time were compared by appropriate statistical tests, using SPSS version 15.0 for Windows and Graph Pad InStat. The results were considered significant for a probability less than 5% (p <0.05). This work is presented in the format of a scientific paper. The article analyzes the changes in clinical periodontal parameters occurred during the six month follow up. The mean age of patients was 43.82 (± 15.56) years, with a majority of Caucasian (71.4%) and histological type of squamous cell carcinoma (78.6%), and higher prevalence of mouth (53.6%). The mean of probing depth decreased in healthy and affected sites, but significantly only in affected sites between the baseline measurement and 180 days after radiotherapy (p <0.01). The mean gingival recession increased in healthy sites (p=0. 001) and affected sites (p=0.023), with significant differences between the baseline measurement and 180 days after radiotherapy (p<0.001). Control of periodontal patients through regular appointments, education and reinforcement of oral hygiene can contribute to stability of the clinical periodontal parameters. The findings of this study showed that patients treated with radiotherapy in the region of the upper airways with or without chemotherapy did not show worsening on clinical periodontal condition during the six-month study.