Impact of radiotherapy in chemical composition and mechanical properties of human cervical dentin: an in vitro study.

Background: Ionizing radiation directly affects hard dental tissues, compromising the dental structure, which results in damage to dentin collagen fibers and impacts the integrity of the dentin-enamel junction (DEJ).

Objective: To evaluate the effects of radiotherapy on the chemical composition and mechanical properties of human cervical dentin.

Methodology: Ten third molars were divided into control/non-irradiated and irradiated groups (n=5). The irradiated teeth were subjected to in vitro radiotherapy with the following protocol: 1.8 Gy daily, five days per week for eight weeks, totaling 72 Gy. The dentin in the cervical region was evaluated for each group. The chemical composition was assessed using Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy, focusing on the mineral/matrix ratio (M:M), carbonate/mineral ratio (C:M), and amide I/amide III ratio. Amide I/CH2 ratio was used to assess collagen quality, as amide I reflects protein conformation and hydrogen bonding, while CH2 indicates side-chain vibrations with low sensitivity to molecular orientation. Nanohardness and elastic modulus were evaluated by instrumented indentation. Scanning electron microscopy (SEM) was used to assess the enamel's morphology. Statistical analysis of each parameter was performed using a t-test.

Results: The FTIR analysis showed statistically significant differences in the C:M ratio (p=0.004) and amide I/amide III ratio (p=0.007). Raman spectroscopy revealed significant differences in the M:M ratio (p<0.001), as well as in the amide I/amide III (p<0.001) and amide I/CH2 ratios (p<0.001). Additionally, nanohardness (p=0.04) and the elastic modulus (p=0.003) showed statistically significant differences. SEM images revealed sound dentin shows normal tissue organization, whereas irradiated dentin showed no clear limit between peri and intertubular dentin.

Conclusions: Radiotherapy induced significant changes in dentin composition and mechanical properties, characterized by increased organic content and phosphate levels, reduced carbonate, and decreased nanohardness and elastic modulus. These findings highlight the adverse effects on dentin's structural integrity.