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Spectroscopic analyses reveal radiotherapy-induced variations in elemental composition and crystallite properties of human permanent teeth enamel
Authors:Jagadish Kudkuli  Riaz Abdulla  P.D. Rekha  S.D. Sharma  Omprakash Gurjar
Affiliation:1. Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India;2. Department of Oral Pathology, Yenepoya Dental College, Mangalore, Karnataka, India;3. Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT&CRS, Anushakthinagar, Mumbai, India;4. Department of Radiotherapy, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India;5. Department of Biomaterials and Research Centre, Yenepoya Dental College, Mangalore, Karnataka, India;6. Homi Bhabha National Institute, Anushaktinagar, Mumbai, India
Abstract:ObjectiveTo study the effect of radiation therapy on the structural and elemental composition of permanent teeth enamel in vitro.MethodsSections from 21 noncarious healthy human teeth were exposed to a cumulative radiation dose of 20–80 Gy. The sections were subjected to electron dispersive spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) analysis to study the elemental composition, the ratio of inorganic and organic content, and the mineralization and crystalline properties of the hydroxyapatite crystal structure respectively. All measures were taken on specified areas of enamel surface before and after radiation exposure and compared.ResultsIn FTIR and EDS studies, the calcium to phosphorus (Ca/P) and carbonate to phosphate (CO32?/PO3-4) ratios were significantly different (P < 0.05) in teeth sections exposed to 80 Gy, indicating the deterioration of inorganic calcium and phosphorous content. The XRD spectrum data showed loss of peaks at seven specific 2θ coordinate areas, flattened peaks and an increase in the crystallite size in the radiation-exposed groups due to mineralization loss and alteration of the hydroxyapatite crystal matrix in the tooth enamel.ConclusionsRadiotherapy can induce significant variations in the inorganic and organic functional groups constituting the tooth enamel surface; and these variations are dose dependent. The mechanism responsible for delamination and radiation caries needs to be explored by studying the protein lysis pattern, which might be a leading factor causing the enamel degradation and radiation caries.
Keywords:Corresponding author. Department of Oral Pathology, Department of Biomaterials & Research Centre, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, 575018, India.  Head and neck cancer  Radiotherapy  Adverse effects  Enamel  Elements  HNCs  Head and neck cancers  EDS  electron dispersive spectroscopy  ATR-FTIR  Attenuated total reflectance- Fourier transform infrared spectroscopy  XRD  X-ray diffraction  RT  Radiation therapy  TPS  Treatment planning system  TCP  Tumor control probability  NTCP  Non target tissue complication probability  ORN  Osteoradionecrosis  QOL  Quality of life  FE-SEM  Field emission scanning electron microscopy  XRD  X ray diffraction  PBS  Phosphate buffer saline  LINAC  Linear accelerator  FWHM  The full width at half maximum  JCPDS  Joint Committee on Powder Diffraction Standards  DAE-BRNS  Department of atomic energy- Board of research in nuclear sciences  DST-PURSE  Department of science and technology- Promotion of university research and scientific excellence  CIF  Central instrumentation facility  MIT  Manipal institute of technology
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