Are intraoral stents effective in reducing oral toxicities caused by radiotherapy? A systematic review and meta-analysis.

Autor: Brandão TB; Coordinator, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., da Graça Pinto H; PhD student, Prostheses and Maxillofacial Traumatology, Dental School of the University of São Paulo (FOUSP), São Paulo, São Paulo, Brazil., Vechiato Filho AJ; Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: aljomarvechiatoflo@gmail.com., Faria KM; Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., de Oliveira MCQ; Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Prado-Ribeiro AC; Assistant, Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Dias RB; Professor, Prostheses and Maxillofacial Traumatology, Dental School of the University of São Paulo (FOUSP), São Paulo, São Paulo, Brazil., Santos-Silva AR; Assistant Professor, Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil., Batista VES; Associate Professor, Department Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: The Journal of prosthetic dentistry [J Prosthet Dent] 2022 Dec; Vol. 128 (6), pp. 1380-1386. Date of Electronic Publication: 2021 Apr 18.
DOI: 10.1016/j.prosdent.2021.03.009
Abstrakt: Statement of Problem: Intraoral stents have been provided to minimize acute and chronic toxicities induced by radiotherapy, including oral mucositis, salivary changes, trismus, radiation-related caries, and osteoradionecrosis. However, a systematic review and meta-analysis is necessary to determine their effectiveness.
Purpose: The purpose of this systematic review and meta-analysis was to determine the effectiveness of intraoral stent use and determine whether these prosthetic devices can reduce radiation dosage to nontargeted oral tissues and adverse effects related to head and neck radiation.
Material and Methods: Two independent reviewers made a systematic search for articles published from January 2010 to March 2020 in 3 databases, supplemented by a manual search. Studies were included if they were clinical trials (randomized controlled trials, both prospective and retrospective), published in English, and evaluated radiation dose and oral adverse side effects (acute or chronic) induced by radiotherapy of participants with and without intraoral stents.
Results: The search strategy identified 201 studies; of which, 9 were included. A total of 251 participants were evaluated; of whom, 168 (77.3%) used intraoral stents and 57 (22.7%) were treated with radiotherapy without a prosthetic device. A statistically significant difference was found regarding the use of intraoral stents for preventing oral mucositis (P<.001), salivary changes (P=.003), and trismus (P<.02). A funnel plot showed asymmetry among the differences of means in all selected studies.
Conclusions: Intraoral stents have a positive effect on preventing oral mucositis. Further clinical trials are needed to address the flaws identified in the present systematic review.
(Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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