Long term oral and dental effects in adolescents who were treated for cancer in childhood

Abstract

Background: Survival following childhood cancer has increased considerably. We examined associations of specific types of cancer therapy with the presence of oral and dental abnormalities among childhood cancer survivors. Procedure: 131 children who were diagnosed with malignancies during childhood were referred to full oro-dental exams. Permanent teeth were examined clinically and radiographically to identify dental caries and anomalies in dental developmental: hypocalcification or hypoplasia, microdontia, root changes and absent tooth bud categorized hypodontia. Results: Dental developmental anomalies were observed in 56 (46%) of 121 children, in 309 teeth (9%). Hypocalcification or hypoplasia of enamel appeared in 21 (17%) patients. The mean decayed, missing and filled teeth (DMFT) score was 6.69 (SD 6.19). Altered root development appeared in 26 patients and hypodontia affected 13 (10%). Dental anomalies were observed in 36 (43%) individuals who received chemotherapy and not radiation, in 20 (52.63%) who received radiotherapy, and in 15 (60%) of those who received head & neck radiotherapy. Young age (under 6 years) was associated with a higher number of malformed teeth among patients who received only chemotherapy. Various chemotherapy agents associated similarly with dental anomalies and also with DMFT. Conclusions: Antineoplastic treatment that combines chemotherapy and radiotherapy appears to increase the risk of developing serious dental anomalies. Radiation to the head and neck area particularly increases the risk of dental developmental anomaly. No specific chemotherapy agent was found to be associated more than the others with dental side effects.

Prevalence of, and risk factors for, dental sequelae in adolescents who underwent cancer therapy during childhood

“…Owosho et al (2016), and Seremidi et al (2019) in their systematic review also reported microdontia to be the most frequent alteration. These results coincide with ours, but other studies found that the most common dental sequelae were root changes followed by microdontia (Çetiner et al, 2019; Halperson et al, 2020; Kang et al, 2018; Seremidi et al, 2021). The calcification of the first premolars begins between the ages of 1.5 and 2 years, and that of the second premolars and second molars between 2 and 2.5 years and 2–2.5 and 3 years, respectively.…”

“…Most of the patients in our sample (85.3%) presented at least one dental sequela as a result of the cancer therapy received, a rate similar to those recorded in other studies (Kang et al, 2018; Kılınç et al, 2019; Nishimura et al, 2013; Owosho et al, 2016; Proc et al, 2016). However, there was a wide variation in the frequency of dental alterations, and other studies have reported much lower percentages (Elzembely et al, 2019; Halperson et al, 2020; Proc et al, 2016). These differences in the frequency of dental alterations can be attributed to the age at which treatment was started, the stage of dental maturity at the time of the clinical examination, the type of cancer therapy administered, and the radiation received, especially in the head and neck region, and the methodological diversity of the studies.…”

“…However, there was a wide variation in the frequency of dental alterations, and other studies have reported much lower percentages (Elzembely et al, 2019;Halperson et al, 2020;Proc et al, 2016). These differences in the frequency of dental alterations can be attributed to the age at which treatment was started, the stage of dental maturity at the time of the clinical examination, the type of cancer therapy administered, and the radiation received, especially in the head and neck region, and the methodological diversity of the studies.…”

“…Abbreviations: CT, chemotherapy; HSCT, hematopoietic stem cell transplantation; RT, radiotherapy. (Çetiner et al, 2019;Halperson et al, 2020;Kang et al, 2018;Seremidi et al, 2021). The calcification of the first premolars begins between the ages of 1.5 and 2 years, and that of the second premolars and second molars between 2 and 2.5 years and 2-2.5 and 3 years, respectively.…”

“…Among irreversible dental sequelae are alterations both in the number of the teeth and in their coronal and radicular development. Dental alterations such as enamel mineralization defects, microdontia, agenesis, root shortening, root growth retardation and malformation, taurodontism, and eruption alterations have been described (Çetiner et al, 2019; Halperson et al, 2020; Hoogeveen et al, 2020; Jodłowska & Postek‐Stefańska, 2021; Johnston et al, 2021; Kang et al, 2018; Kılınç et al, 2019; Maciel et al, 2009; Nemeth et al, 2013; Owosho et al, 2016; Proc et al, 2016; Seremidi et al, 2021; Wilberg et al, 2016).…”