Clinical evaluation of a self-adhering material as desensitizing agent in xerostomic patients for head and neck cancer

Xerostomia is a common clinical symptom that may suffer patients with Head and Neck Cancers during and after radiotherapy. The aim of the present thesis were therefore: 1) to review the current state of knowledge of pathology, clinical complications and radiotherapeutic patient management, 2) to evaluate the aetiology of dentine hypersensitivity in conditions of reduced salivary flow resulting in the radiation exposure, 3) to evaluate the effectiveness of the materials commonly used in the treatment of hypersensitivity, when they work in conditions of hyposalivation. Paper I is systematic review of actual management strategies for radiation-induced hypofunction and xerostomia in head and neck cancer patients. Paper II and III are based on the data of two split-mouth randomized clinical trial, where the efficacy of 4 different kinds of desensitizers has been assessed in the short and long term on patients with normal salivary flow. Paper IV is a long term evaluation based on the same experimental protocol applied on xerostomic patients. The main conclusions from this thesis are that: 1) the radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia. 2) In xerostomic condition all the materials tested produced a significant reduction in the dentine sensibility. In light of the observed data, after 12-week controls there is no statistically significant difference between the desensitizers and they show a less stable behaviour compared to the normal salivation condition.