【摘要】 目的　分析牙放射性损伤的各种因素及防治方法。方法　放疗后病人 10 0例 ,其中牙照射组 6 0例 ,牙未照射组 4 0例。自身对照组 15例。治疗方法均为常规分割照射。结果　两组分别在 2 0个月内龋齿发病率为 6 0 %、15 % ,P <0 0 1。自身对照组 15例患侧发病率明显高于健侧。 6例患者牙的吸收剂量为 70Gy者发病率为 10 0 %。结论　作者认为放射性牙损伤 :(1)与吸收剂量、放射部位有密切关系。 (2 )牙齿内活跃的造釉细胞、造牙本质细胞对射线敏感。 (3)唾液腺的破坏造成唾液素下降pH值下降 ,链球菌大量繁殖。防治方法 :用防龋涂料 ,牙罩 ,计划性保护唾液腺 ,调整时间剂量因子 ,选择适形放疗技术 ,保护牙髓细胞的增殖能力 ,抗炎 ,改善微循环 ,增强全身抵抗力 ,是防龋齿的关键。更多还原

【Abstract】 Objective To analyze various factors inducing teeth damage from radiotherapy and the preventive and treatment methods. Methods One hundred cases of patients treated by radiotherapy were divided into two groups. In group one there were 60 cases whose teeth were irradiated during treatment;in group two there were 40 cases whose teeth were not irradiated during treatment. Results The caries incidence was 60% for group one and 15% for group two( P <0.01).By auto-control in 15 patients, the caries incidence on the sick side was obviously higher than that of the healthy side. Hundred percent caries incidence was found in 6 cases who received a dosage of 70 Gy. Conclusion The authors believe that radiation damage to the teeth is associated with the following factors:1. The dosage and location of irradiation are closely related to caries incidence;2.The active dentinoblasts are very sensitive to radiation;3.Damage to the salivary glands from radiotherapy can result in reduction of salvia and pH value,leading to a high growth rate of Streptococcus mutans. Following preventive measures could be considered in future cases: to apply a caries prevention coating or protective dental crown and TPS, to adjust the dose and time of irradiation, to select conformal radiotherapy technique. The key points for protecting the teeth and salivary gland from caries and damage are protection of the proliferation ability of pulp cells, anti-inflammation, promotion of microcirculation, and strengthening body resistance.更多还原