Supportive Care in Cancer

, Volume 28, Issue 1, pp 239–247 | Cite as

Radiotherapy impairs adhesive bonding in permanent teeth

  • Juliana AridEmail author
  • Regina Guenka Palma-Dibb
  • Harley Francisco de Oliveira
  • Paulo Nelson-Filho
  • Fabricio Kitazono de Carvalho
  • Lea Assed Bezerra da Silva
  • Talitha de Siqueira Mellara
  • Raquel Assed Bezerra da Silva
  • Juliana Jendiroba Faraoni
  • Alexandra Mussolino de Queiroz
Original Article



To evaluate the in vitro effects of radiotherapy (RT) on the morphological surface of the enamel and dentin and to determine the best adhesive system and most appropriate time to restore teeth in head and neck cancer patients.


Sixty third molars were cut into 120 enamel fragments and 120 dentin fragments and divided into four groups (n = 30): G1 (control): nonirradiated, only restorative procedure; G2: restorative procedure immediately before RT; G3: restorative procedure immediately after RT; and G4: restorative procedure 6 months after RT. Each group was divided into two subgroups: Adper™ Single Bond 2 (SB) and Clearfill SE Bond (CL) based on the material used. After RT and restorative procedures, the specimens were subjected to confocal microscopy and shear bond strength test. Data were analyzed using a two-way ANOVA followed by Tukey’s test at a significance level of 5%.


Morphological changes were observed in both substrates after a cumulative dose of 40 Gy, and after 60 Gy, the changes were more evident in both substrates. CL had the highest strength values in both substrates (p < 0.05), and G2 had the lowest strength values for the enamel and dentin (p < 0.05).


Based on the in vitro study results, we can conclude that RT substantially changes the morphological surface of enamel and dentin and impairs the bond strength. The Clearfill system yielded better results than Adper Single Bond 2, and restoring teeth before RT resulted in the worst results in both substrates.


Radiotherapy Head and neck neoplasms Dental enamel Dentin Dental bonding Confocal microscopy 


Funding source

This study was funded by the Brazilian Ministry of Education’s Federal Agency for Support and Evaluation of Graduate Education Coordination of Training of Higher Education Graduate (“CAPES”).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest

This study did not involve human participants and/or animals, and formal consent was not required.

No financial relationship exists with the organization that sponsored this research.

We have full control over all primary data, and agree to allow the journal to review the data if requested.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Juliana Arid
    • 1
    Email author
  • Regina Guenka Palma-Dibb
    • 2
  • Harley Francisco de Oliveira
    • 3
  • Paulo Nelson-Filho
    • 1
  • Fabricio Kitazono de Carvalho
    • 1
  • Lea Assed Bezerra da Silva
    • 1
  • Talitha de Siqueira Mellara
    • 1
  • Raquel Assed Bezerra da Silva
    • 1
  • Juliana Jendiroba Faraoni
    • 2
  • Alexandra Mussolino de Queiroz
    • 1
  1. 1.Department of Pediatric DentistryUniversity of São Paulo-School of Dentistry of Ribeirão PretoRibeirão PretoBrazil
  2. 2.Department of Restorative DentistryUniversity of São Paulo-School of Dentistry of Ribeirão PretoRibeirão PretoBrazil
  3. 3.Department of Internal Medicine, Ribeirão Preto School of MedicineUniversity of São PauloRibeirão PretoBrazil

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