Craniomandibular dysfunction in children treated with total-body irradiation and bone marrow transplantation.
The prevalence of pain and dysfunction in the stomatognathic system was studied in a group of 19 long-term survivors after pediatric bone marrow transplantation (BMT), conditioned with total-body irradiation (TBI). Compared with the control group, the children and adolescents in the BMT group had a significantly reduced mouth opening capacity. A reduced translation movement of the condyles was diagnosed in 53% of children treated with TBI, compared with 5% in the control group. Signs of craniomandibular dysfunction were found in 84% of children in the BMT group, compared with 58% in the control group. Both irradiation and chemotherapy induce long-term alterations in connective and muscle tissues resulting in inflammation and eventually fibrosis. These changes in tissue homeostasis and concomitant growth retardation may lead to the observed malocclusion and reduced mobility of the temporomandibular joint, with subsequent muscle pain and headaches, which were found in this study.
Dahllöf
G
G
Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden.
Krekmanova
L
L
Kopp
S
S
Borgström
B
B
Forsberg
C M
CM
Ringdén
O
O
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D017271:Craniomandibular Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D007951:Leukemia, Myeloid / Q000601:surgery; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008334:Mandible / Q000503:physiopathology; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000503:physiopathology; D008410:Masticatory Muscles / Q000503:physiopathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery; D015995:Prevalence; D011859:Radiography; D013705:Temporomandibular Joint Disorders / Q000209:etiology; D014916:Whole-Body Irradiation / Q000009:adverse effects*