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Updated: Feb 6, 2026
Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
Cracked tooth syndrome in irradiated patients with head and neck cancer
Natalia Rangel Palmier1, Cristhian Camilo Madrid2, Mariana de Pauli Paglioni1
1Oral Diagnosis, Piracicaba Dental School, UNICAMP, Brazil.
Objectives:
The aim of this study was to assess the presence of enamel craze lines (ECLs), part of the spectrum of the so-called cracked tooth syndrome, on the surface of teeth irradiated in vivo.
Study Design:
Forty teeth extracted from patients with head and neck cancer were paired, matched, and equally divided into 4 groups: noncarious irradiated (G1); noncarious control (G2); radiation-related caries (RRC) (G3), and carious control (G4). Samples were examined for ECL detection with a fiberoptic transillumination device and photographed, and ECL mean size, number, and patterns of topographic distribution in tooth crown were determined. Groups were compared accordingly: G1 versus G2; G3 versus G4.
Results:
We analyzed 538 ECLs, of which 30.1% were found in noncarious irradiated teeth, 19.3% in noncarious controls, 27.6% in RRC, and 23% in carious controls. Non-carious irradiated teeth presented higher quantities of ECL than non-carious control (P < 0.05). Higher incidences of ECLs were identified in specific enamel topographies of anterior G1 and G3 samples (P <.05). There was no correlation between ECL size/numbers and radiation isodose delivery to teeth.
Conclusions:
Increased incidence of ECLs may indicate weakened enamel structure in irradiated teeth, and this may play a role in the onset and progression of RRC.
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