A critical look at prevalence assessment of dental abnormalities after chemotherapy. Clinical research

Abstract

Introduction: Dental abnormalities are relatively frequent among late complications of anticancer treatment received by patients at a young age. Available statistical reports are based on different research methods providing various results. Objectives: The purpose of the study was to assess the prevalence of agenesis and reduction in crown size in cancer survivors and healthy subjects with special attention to the age at which treatment was begun and therapy duration related to the developmental stage of the affected teeth. Material and methods: Cancer survivors and their healthy peers were examined clinically and radiographically towards an existence of hypodontia and changes in the dental crown size. Results: Cancer survivors had abnormalities examined in the prevalence of 62.16% and total number of 100 teeth disturbed. Significantly lower prevalence (13.51%) and smaller number of teeth affected (10) were disclosed in the control group. After the affected teeth were divided into developmental groups, the mean age at the time of anticancer therapy varied noticeably and corresponded with expected time of early tooth development. Analysis revealed that 80% of survivors with hypodontia, 91.67% with microdontia, and 100% with teeth reduced in size received the therapy at the expected early development. Conclusions: The findings of the study showed a strong correlation between the age at the therapy and the expected time of odontogenesis of teeth affected in almost 98% of cases.

Systemic Anticancer Therapy Details and Dental Adverse Effects in Children

“…This is clearly shown in Table 3 and Table 4 . It is also in accordance with some papers found in the literature [ 9 , 26 ]. Thanks to observational studies on cancer survivors, the adverse effects of all environmental factors influencing dental development may not be expected in the preschool stage in children.…”

“…They received their anticancer treatment in the period which is not considered critical, and even though the therapy was very long, no noticeable dental changes were noted. The phenomenon was already addressed in one of the authors’ previous papers [ 26 ]. In another study by the author, no significant differences in therapy duration were found between the affected and non-affected survivors within almost all groups of dental abnormalities for each drug.…”

“…This is why that problem is not taken into consideration in the current study. A number of factors increasing the risk for dental abnormalities such as the age at diagnosis, stage of dental development or type and duration of chemotherapy are still being evaluated [ 11 , 12 , 26 , 32 ]. Thorough analyses of treatment details taking into account also the age at diagnosis and duration of the entire therapy are uncommon in the literature.…”

“…Moreover, the impact of some anticancer drugs was also illustrated histologically on either the animal model or deciduous human teeth [ 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. In one of the authors’ recent papers, it was reported that up to 92% of the total number of abnormal teeth found in the study could have had the injury caused by antineoplastic therapy because the treatment time overlapped with their expected odontogenesis [ 26 ]. However, why some teeth are abnormal, and some are properly developed, is still open to debate in the context of the drug dose level, treatment intervals and others.…”

Tooth development in the light of chemotherapy-induced agenesis in cancer survivors

“…There are many experimental animal studies reporting dental damage after vincristine, cyclophosphamide, or actinomycin D administration [6][7][8]. It is widely documented that agenesis, microdontia, taurodontism, disturbed root development or enamel opacities, and hypoplasia are diagnosed in children treated with multi-agent therapy [9][10][11][12][13][14][15]. The reported prevalence of hypodontia is estimated to be 7-77%, depending on inclusion criteria [10,13,14,[16][17][18].…”