Background: Odontological effects of ionizing radiation (IR) as a result of radiotherapy, the consequences of accidents at nuclear power plants and industry, individual occupational exposure, etc. deserve significant attention interns of radiation medicine and radiation safety.
Objective: to analyze and summarize clinical and experimental data on the odontological radiation effects.
Object: the pathological changes in the hard tissues of teeth, pulp, periodontium, mucousmembranes of the mouth and jaws due to exposure to IR.
Method: search in the PubMed / MEDLINE, Google Scholarabstract medical and biological databases, scientific libraries of the relevant sources of scientific information.
Results: Radiobiological effects of IR due to its direct and indirect action are manifested throughout the period ofodontogenesis and formation of the facial skeleton. Experimental and clinical data (in children and adults) indicatethe increased risk of dental caries, reduction of pain threshold and vascularization of tooth pulp along with its fibrosis and atrophy, periodontal dysfunction, which predispose to a high probability of tooth loss. Abnormalities in theactivity of osteoblasts and cementoblasts of dental periosteum and osteoblasts of alveolar process in combinationwith circulatory disorders due to endothelial cell death, hyalinization, thrombosis and vascular obliteration increasethe risk of jaw osteoradionecrosis. Children who have undergone a prenatal exposure to IR as a result of theChornobyl NPP accident have a premature change of teeth. Deterioration of periodontal tissues and early development of acute and complicated dental caries are typical for children and adults affected by the Chornobyl disaster.
Conclusions: Summarized data on the effects of radiation exposure under different conditions on teeth primordia(i.e. immature teeth), their formation and eruption in experimental and clinical settings, as well as on the odontological radiation effects in adults are summarized. Condition of the teeth in the Chornobyl NPP accident survivorsis described. Understanding and taking into account the radiobiological odontological effects is necessary in thelight of planning, preparing, and conducting local radiation therapy and developing the standards of radiation safety and measures to protect professionals and the public in the event of possible radiation accidents at the nuclearpower plants and industry facilities.
Peredumova. Odontologichni efekty vplyvu ionizuiuchogo vyprominiuvannia (IV) iak rezul'tat radioterapiï,naslidok avariĭ na pidpryiemstvakh iadernoï energetyky ta promyslovosti, pry indyvidual'nomu profesiĭnomu oprominenni toshcho varti istotnoï uvagy na zasadakh radiatsiĭnoï medytsyny i radiatsiĭnoï bezpeky.Meta: proanalizuvaty i uzagal'nyty klinichni ta eksperymental'ni dani stosovno odontologichnykh radiatsiĭnykhefektiv.Ob’iekt i metody doslidzhennia. Ob’iekt: patologichni zminy tverdykh tkanyn zubiv, pul'py, parodontu, slyzovoï obolonky porozhnyny rota i shchelep vnaslidok vplyvu IV. Metod: poshuk u referatyvnykh medyko-biologichnykh bazakhdanykh PubMed/MEDLINE, Google Scholar, naukovykh bibliotekakh vidpovidnykh dzherel naukovoï informatsiï.Rezul'taty. Radiobiologichni efekty IV vnaslidok ĭogo priamoï ta nepriamoï diï proiavliaiut'sia protiagom us'ogoperiodu odontogenezu ta formuvannia lyts'ovogo skeletu. Eksperymental'ni ta klinichni dani (dity i dorosli)svidchat' pro zrostannia ryzyku vynyknennia kariiesu; znyzhennia bol'ovogo porogu ta vaskuliaryzatsiï pul'py zuba,ïï fibroz ta atrofiiu; porushennia funktsionuvannia parodontu, shcho zumovliuie vysoku ĭmovirnist' vtraty zubiv.Zminy aktyvnosti osteoblastiv i tsementoblastiv zubnogo periostu ta osteoblastiv al'veoliarnogo parostka vpoiednanni z porushenniam krovoobigu vnaslidok zagybeli endotelial'nykh klityn, gialinizatsiï, trombozu ta obliteratsiï sudyn zumovliuiut' zrostannia ryzyku osteoradionekrozu shchelep. Ditiam, iaki zaznaly prenatal'nogo oprominennia vnaslidok avariï na Chornobyl's'kiĭ AES, prytamanna peredchasna zmina zubiv. Pogirshennia stanu tkanyn parodontu, ranniĭ rozvytok gostrogo ta uskladnenogo perebigu kariiesu zubiv kharakternyĭ dlia diteĭ ta doroslykh, postrazhdalykh vnaslidok Chornobyl's'koï katastrofy.Vysnovky. Uzagal'neno dani shchodo naslidkiv promenevogo vplyvu za riznykh umov na zachatky zubiv, ïkh formuvannia i prorizuvannia v eksperymenti i klinichnykh umovakh, a takozh – shchodo odontologichnykh radiatsiĭnykh efektiv u doroslykh osib. Okharakteryzovano stan zubiv osib, postrazhdalykh vnaslidok avariï na ChAES. Rozuminnia i vrakhuvannia radiobiologichnykh odontologichnykh efektiv neobkhidni pry planuvanni, pidgotovtsi i provedenni lokal'noï promenevoï terapiï ta rozrobtsi standartiv radiatsiĭnoï bezpeky i zakhodiv zakhystu profesiĭno pratsiuiuchykh osib i naselennia pry ĭmovirnykh radiatsiĭnykh avariiakh na pidpryiemstvakh iadernoï energetyky ta promyslovosti.
Keywords: Chornobyl NPP accident; caries; dentin; ionizing radiation; odontogenesis; odontology; periodontium; pulp; radiation therapy; tooth enamel.
D. E. Afanasyev, S. F. Liubarets.