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

Abstract

IntroductionThe increase in survival rates in children treated for cancer has been accompanied by a rise in sequelae in permanent teeth. The aim of the study was to correlate the type of cancer therapy administered to patients during early childhood and the dental sequelae recorded in survivors.Material and methodsSingle‐center retrospective cohort study carried out at the Children's University Hospital of Sant Joan de Déu in Barcelona, Spain. Hundred and nine patients who had received cancer treatment during early childhood were randomly examined and grouped according to diagnosis and cancer therapy received. The type of therapy was correlated with the number and severity of dental lesions that patients presented in adolescence.ResultsDental sequelae of some kind were present in 85.3% of patients. Microdontia was the most prevalent (52.3%). Treatment with alkylating agents had a relative risk of presenting moderate lesions of 3.36 (1.18–9.60), and one of 2.29 (1.07–4.91) of presenting severe lesions. Topoisomerase inhibitors and cytotoxic antibiotics presented relative risks of 1.6 (1.07–2.38) and 2.08 (1.02–4.26) of root alterations and agenesis, respectively.ConclusionsTreatment with alkylating agents together with cytotoxic antibiotics and topoisomerase inhibitors was associated with a higher relative risk of microdontia, agenesis, and root shortening.

Chemotherapy and Radiotherapy Long-Term Adverse Effects on Oral Health of Childhood Cancer Survivors: A Systematic Review and Meta-Analysis

“…Overall, a total of 3761 participants from all 35 included studies were included in this systematic review, 2625 childhood cancer survivors (889 females and 1122 males, 10 did not report sex) and 1136 healthy children (209 females and 243 males, 11 did not report sex) ( Table 1 ). All studies addressed long-term adverse oral health effects in childhood cancer survivors, although 14 studies did not present a control group [ 4 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ].…”

“…Regarding the type of study, 15 were cohort studies [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], 13 case–control studies [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], and 7 cross-sectional studies [ 3 , 4 , 15 , 16 , 25 , 46 , 47 ].…”

“…Several points were considered in the case definition setting. Some studies addressed multiple topics: 24 assessed caries incidence [ 4 , 15 , 17 , 22 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 36 , 37 , 39 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 ], 18 assessed dental abnormalities such as root stunting and microdontia [ 4 , 16 , 18 , 20 , 21 , 23 , 26 , 27 , 29 , 39 , 40 , 41 , 43 , 44 , 46 , 47 , 48 ], and 15 stressed the developmental defects of enamel [ 16 , 17 , 21 , 23 , 26 , 27 , 29 , 30 , 36 , 40 , 41 ,…”

“…Discoloration was the most prevalent dental anomaly, with a mean prevalence of 53% (0.53, 95% CI: 0.42; 0.65), but was less described (only in four studies) [ 17 , 26 , 28 , 44 ]. The second dental anomalies most prevalent, with 36% prevalence, were crown-root malformations (0.36, 95% CI: 0.28; 0.44) and agenesis (0.36, 95% CI: 0.27; 0.45), both described in 10 studies [ 16 , 21 , 23 , 26 , 27 , 28 , 29 , 39 , 42 , 44 ], followed by 32% prevalence of enamel hypoplasia (0.32, 95% CI: 0.21; 0.45), described in 13 studies [ 4 , 16 , 20 , 21 , 26 , 27 , 28 , 29 , 30 , 39 , 40 , 41 , 44 ]. With 29% (0.29, 95% CI: 0.16; 0.43) prevalence, root development alterations were described in 10 studies [ 4 , 21 , 23 , 26 , 27 , 28 , 29 , 39 , 40 , 44 ].…”

“…The second dental anomalies most prevalent, with 36% prevalence, were crown-root malformations (0.36, 95% CI: 0.28; 0.44) and agenesis (0.36, 95% CI: 0.27; 0.45), both described in 10 studies [ 16 , 21 , 23 , 26 , 27 , 28 , 29 , 39 , 42 , 44 ], followed by 32% prevalence of enamel hypoplasia (0.32, 95% CI: 0.21; 0.45), described in 13 studies [ 4 , 16 , 20 , 21 , 26 , 27 , 28 , 29 , 30 , 39 , 40 , 41 , 44 ]. With 29% (0.29, 95% CI: 0.16; 0.43) prevalence, root development alterations were described in 10 studies [ 4 , 21 , 23 , 26 , 27 , 28 , 29 , 39 , 40 , 44 ]. Unerupted teeth had a mean prevalence of 24% (0.24, 95% CI: 0.15; 0.34), and this condition was described in four studies [ 26 , 28 , 42 , 44 ], with microdontia at 16% (0.16, 95% CI: 0.09; 0.24), but this was the most commonly described dental anomaly in 14 studies [ 4 , 17 , 18 , 19 , 20 , 23 , 26 , 27 , 28 , …”