The effects of radioiodine treatment on caries incidence in patients with differentiated thyroid carcinoma.

Hoekstra, J. (2014) The effects of radioiodine treatment on caries incidence in patients with differentiated thyroid carcinoma. thesis, Dentistry.

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Abstract

Background As a result of the growing knowledge in diagnosis, treatment and characteristics of a variety of malignancies, treatment outcomes becomes more favorable causing the number of patients who survive cancer is growing and the interest in long-term side-effects of cancer treatment increases. Treatment of DTC has a 10-year survival rate of 80-95%2. After a total thyroidectomy the treatment continues with radioiodine (I-131) ablation therapy. I-131 is taken up by the remaining thyroid tissue and destroys the residual normal and malignant thyroid cells. Salivary glands can also concentrate iodine8, whereby they are at risk for radiation injury which can result in hyposalivation and an increased risk of developing oral problems such as oral infections and dental caries. Research question The primary goal of the study is to determine whether the caries incidence is significantly increased in DTC patients after I-131-treatment compared with the caries incidence before this treatment. Secondary goals are to determine whether caries incidence is correlated with cumulative I-131-dose, xerostomia questionnaire score, saliva flow-rate, saliva pH and pattern of carious lesions. Methods The study population exists of DTC patients who are in follow-up for DTC for at least 4 years at the outpatient clinic of the Department of Endocrinology of the UMCG. Patients were extracted from the digital medical record system of the UMCG. Patients who had an appointment for checkup in the period of February 1st - May 16th 2014 were selected and invited to participate in the study. During the visit the secondary endpoints of the study were obtained. After the visit newly discovered carious lesions and the number of restorations and extractions because of dental caries were extracted from the dental records. The parameters were analysed in SPSS by a paired t-test, a correlation test and an univariate and multivariate linear regression model. Results Twenty-eight participants were included. The t-test gives a mean increase in caries incidence after the I-131 treatment of 0.09 new developed carious lesions more per year which is not significant (p = 0,550). The correlation test and the regression test also show no significant relation between the secondary study parameters and the difference in caries incidence before and after the I-131 treatment. Conclusion The hypothesis “caries incidence in DTC patients is increased after I-131-treatment compared to the caries incidence during the 4 years before I-131-treatment (H1)” can be rejected, as no significant difference in caries incidence was found before and after the I-131 treatment.

Item Type:	Thesis (Thesis)
Supervisor name:	Vissink, Prof.dr. A.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:48
Last Modified:	25 Jun 2020 10:48
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/910

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