Dental Pulp Status of Posterior Teeth in Patients with Oral and Oropharyngeal Cancer Treated with Radiotherapy: 1-year Follow-up.

INTRODUCTION: Teeth may react negatively to pulp sensitivity testing in patients who have undergone radiotherapy. The aim of the current investigation was to evaluate the pulp sensibility of posterior teeth at 4, 6, and 12 months in patients who have undergone radiotherapy for oral and oropharyngeal malignancies.

METHODS: Seventy-nine patients diagnosed with malignant oral and oropharyngeal cancer undergoing radiotherapy underwent cold thermal pulp sensitivity testing and electric pulp testing of 4 teeth, 1 from each quadrant. The results were recorded at 5 different time points (TPs): before radiotherapy (TP1), at the end of radiotherapy at 66-70 Gy (TP2), 4 months after the completion of radiotherapy (TP3), 6 months after the completion of radiotherapy (TP4), and 12 months after the completion of radiotherapy (TP5).

RESULTS: All 288 teeth tested positive to cold thermal pulp sensitivity testing and electric pulp testing (EPT) at TP1 (100%). No tooth responded to the cold test (100%) at TP4 and TP5, and progressively higher EPT values were noted during the observation period. A statistically significant difference existed in the number of positive responses between different TPs.

CONCLUSIONS: There was a progressive decrease in pulp sensibility from TP1 to TP5 in teeth of patients with oral and oropharyngeal cancer who underwent radiotherapy (66-70 Gy). No response to cold thermal tests was noted at TP4 (6 months) and TP5 (12 months), and teeth responded at increasingly higher EPT values from TP1 through TP5. This result was statistically significant.