Análise estrutural comparativa de dentina humana em pacientes com câncer de cabeça e pescoço submetidos à radioterapia
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Data
2021-09-03
Autores
Moreira Júnior, Cláudio [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O câncer de cabeça e pescoço está entre as neoplasias mais prevalentes, sendo seu tratamento realizado por cirurgia, radioterapia, quimioterapia ou uma combinação destes, dependente de fatores como tipo e localização. O método radioterápico destaca-se por ser um método menos invasivo, com possibilidade de regressão da doença e prevenção de possíveis reincidências. Porém, mudanças estruturais e morfológicas podem acontecer nos tecidos duros dentários ao serem irradiados durante o tratamento. Assim, o objetivo deste estudo foi avaliar “in vivo” a influência da radioterapia para tratamento do câncer de cabeça e pescoço sobre a estrutura da dentina humana. Foram utilizados dentes extraídos por motivos periodontais e/ou sujeitos a gerar processos infecciosos graves em caráter de urgência, tanto de pacientes que realizaram radioterapia devido ao diagnóstico de câncer de cabeça e pescoço, como de pacientes saudáveis, aos quais foram separados em dois grupos: Controle (n=12 dentes - dentina de pacientes saudáveis); Irradiado (n=12 dentes - dentina de pacientes irradiados). Os dentes foram seccionados ao meio, obtendo-se duas metades (n=24) para cada grupo. Ambos os grupos (n=24) foram analisados por técnicas não destrutivas: análises de Microdureza de Superfície (MDS), Microscopia Eletrônica de Varredura (MEV) e Espectroscopia por Energia Dispersiva de Raios X (EDS); e os dados obtidos através de EDS foram correlacionados, realizando sua validação matemática, com análise de Fluorescência de Raios X. A análise de MDS não encontrou diferenças significativas; a análise por MEV encontrou diferenças visuais significativas entre as imagens obtidas; a análise por EDS encontrou diferenças significativas nas comparações entre Cálcio e Fósforo (p=0,000 e p=0,037, respectivamente), evidenciando redução de Ca e aumento de P no grupo que sofreu radiação. A correlação matemática foi validada, com padrões satisfatórios de aceitabilidade da precisão e da exatidão na técnica utilizada.
Head and neck cancer is among the most prevalent cancers, and its treatment is performed by surgery, radiotherapy, chemotherapy or a combination of these, depending on factors such as type and location. The radiotherapy method stands out for being a less invasive method, with the possibility of disease regression and prevention of possible recurrences. However, structural and morphological changes may occur in dental hard tissues when irradiated during treatment. Thus, the aim of this study will be to evaluate “in vivo” the influence of radiotherapy to treat head and neck cancer on the structure of human dentin. Teeth extracted for periodontal reasons and/or subject to urgent serious infectious processes will be used, both from patients who underwent radiotherapy for the diagnosis of head and neck cancer and from healthy patients, who will be separated into two groups: Control (n = 12 teeth - dentin of healthy patients); Irradiated (n = 12 teeth - dentin from irradiated patients). The teeth were sectioned in half, obtaining two halves (n = 24) for each group. Both groups (n = 24) were arranged by non-destructive techniques: Surface Microhardness (MDS), Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray Spectroscopy (EDS) analysis; and the data obtained through EDS were correlated, performing its mathematical validation, with X-Ray Fluorescence analysis. MDS analysis did not find differences; SEM analysis found relevant visual differences between the customized images; EDS analysis found differences in the comparisons between Calcium and Phosphorus (p = 0.000 and p = 0.037, respectively), showing a reduction in Ca and an increase in P in the group that underwent radiation. Mathematical correlation was validated, with acceptability standards of precision and accuracy in the technique used satisfactory.
Head and neck cancer is among the most prevalent cancers, and its treatment is performed by surgery, radiotherapy, chemotherapy or a combination of these, depending on factors such as type and location. The radiotherapy method stands out for being a less invasive method, with the possibility of disease regression and prevention of possible recurrences. However, structural and morphological changes may occur in dental hard tissues when irradiated during treatment. Thus, the aim of this study will be to evaluate “in vivo” the influence of radiotherapy to treat head and neck cancer on the structure of human dentin. Teeth extracted for periodontal reasons and/or subject to urgent serious infectious processes will be used, both from patients who underwent radiotherapy for the diagnosis of head and neck cancer and from healthy patients, who will be separated into two groups: Control (n = 12 teeth - dentin of healthy patients); Irradiated (n = 12 teeth - dentin from irradiated patients). The teeth were sectioned in half, obtaining two halves (n = 24) for each group. Both groups (n = 24) were arranged by non-destructive techniques: Surface Microhardness (MDS), Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray Spectroscopy (EDS) analysis; and the data obtained through EDS were correlated, performing its mathematical validation, with X-Ray Fluorescence analysis. MDS analysis did not find differences; SEM analysis found relevant visual differences between the customized images; EDS analysis found differences in the comparisons between Calcium and Phosphorus (p = 0.000 and p = 0.037, respectively), showing a reduction in Ca and an increase in P in the group that underwent radiation. Mathematical correlation was validated, with acceptability standards of precision and accuracy in the technique used satisfactory.
Descrição
Palavras-chave
Radioterapia, Dentina, Microscopia eletrônica de varredura, Espectrometria por raios X, Espectrometria de fluorescência, Radiotherapy, Dentin, Scanning electron microscopy, X-ray emission spectroscopy, Fluorescence spectrometry