Preventive and restorative alternatives to caries by irradiation: a scoping review.

PURPOSE: This study is to conduct a comprehensive scoping review to map scientific evidence and clarify concepts regarding the commonly recommended preventive and restorative dental treatments for patients diagnosed with head and neck cancer (HNC) and subjected to radiotherapy. MATERIAL AND METHODS: This systematic scoping review was performed under the PRISMA-ScR guidelines. The study's experimental design was registered in the Open Science Framework. In vitro studies that evaluated preventive and restorative dental treatment over 50 Gy radiation doses were included. The search was conducted in November 2023 in five electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, and Embase) without language or date restriction. A search strategy was applied based on keywords, MeSh terms, or synonyms. A descriptive analysis was conducted. RESULTS: A total of 49 studies, out of 3679 original articles identified, were included and reviewed. Of the included studies, three evaluated saliva stimulants and 35 evaluated fluoride-based preventive materials: gel (n = 18) toothpaste (n = 11) mouth rinse (n = 8) and varnish (n = 5) while 14 evaluated restorative materials: resin composite (n = 12) glass ionomer cement (n = 6) and amalgam (n = 1) Of those studies, 36 were clinical trials and 13 were in vitro studies. CONCLUSION: Fluoride gel was the most frequently recommended preventive material for preventing radiation caries with supportive clinical evidence. Resin composite and glass ionomer were the most frequently used restorative materials, respectively. However, there is not yet clinical evidence to support the use of resin composite in irradiated teeth.

Mechanical properties of aged yttria-stabilized tetragonal zirconia polycrystal after abrasion with different aluminum oxide particles.

STATEMENT OF PROBLEM: A consensus on the benefits of airborne-particle abrasion of zirconia with alumina particles of different sizes is still lacking. Larger particle size may improve micromechanical retention but may generate deep microcracks on the zirconia surface. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different size of Al2O3 particles used for surface abrasion on the mechanical properties of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). MATERIAL AND METHODS: Sixty Y-TZP specimens were divided into 6 groups according to the treatment: control (without treatment) or airborne-particle abrasion with Al2O3 particles (45 µm or 150 µm). Half the specimens were stored for 24 hours in water while the other half was exposed to 1.5×106 mechanical cycles before flexural strength analysis at 1 mm/min crosshead speed. Specimens were also characterized by micro-Raman spectroscopy and X-ray diffraction (XRD) to evaluate the crystalline composition. The data were subjected to 2-way ANOVA and Tukey HSD test (α=.05). RESULTS: Airborne-particle abrasion with alumina (P=.030) and mechanical fatigue (P<.001) had a significant effect on flexural strength. Specimens abraded with 45-µm Al2O3 particles (847 ±204 MPa) presented higher flexural strength than those of the control group (670 ±210 MPa). The size of the alumina particles was not significant for flexural strength. Flexural resistance (664 MPa) significantly decreased after mechanical fatigue. All groups showed only the tetragonal phase on the micro-Raman spectra, which was confirmed by XRD. CONCLUSIONS: Airborne-particle abrasion with smaller Al2O3 particles increased the flexural strength on Y-TZP without causing phase transformation. However, flexural strength was decreased after mechanical fatigue.