Tooth development in the light of cancer survivors’ examination

Abstract

Introduction. The mechanisms determining the final tooth shape and size are still not well understood. Knowing the precise time of an antineoplastic management and analyzing the subsequent complications resulting from the said harmful therapy may be helpful in finding out more about dental development. Aim of the study. To analyze the process of tooth germ growth on the basis of examination of patients treated with chemotherapy. Materials and methods. A total of ten cancer survivors with tooth agenesis and microdontia were interviewed and underwent clinical and radiographic examinations. Results. In all, 38 disturbed teeth were revealed: 11 missing germs (1 first premolar, 5 second premolars, 3 second molars and 2 lateral incisors) and 27 microdontic teeth (9 first and 5 second premolars, 9 second molars, 2 lateral incisors and 2 third molars). Selected patients underwent cancer treatment between 9 months and 10 years of age. In the majority of cases the age at diagnosis slightly preceded the average time when the mineralization of affected teeth began. Conclusions. Cytotoxic therapy may be responsible for the damage to ectodermal germ cells resulting, among others in hypodontia and microdontia. These abnormalities have been described as occurring at the initiation and bud stage, respectively. Taking into account that chemotherapy was most often administered to the examined patients shortly before tooth germ mineralization, it seems possible the anomalies might have occurred at the later stage of tooth development.

Microdontia after chemotherapy in a patient treated for neuroblastoma: Histopathological findings

“…Thorough analysis of anticancer treatment time in relation to the type of tooth abnormality could make it possible to take a look at the mechanisms of odontogenesis. 21 Some histological studies in which the impact of cytotoxic drugs on dentinogenesis is presented may be found in the literature. Polarized microscopy appeared to be helpful in showing regular incremental lines in the dentin, corresponding to intravenous chemotherapy administration, although the tooth morphology was not changed.…”

“…In the authors' previous research, the majority of patients with microdontia started their antineoplastic treatment before or at the expected time of the onset of apposition. 21 This may be the evidence of a short period within the bell stage when the tooth shape is being determined.…”

“…Severe dental damage is a long-term side effect and may occur after long-term chemotherapy at early developmental stages. 4,21 Reports based on the histological examination of teeth damaged before the onset of apposition are missing.…”