Long-term dental development in children after treatment for malignant disease.
A radiographic dental examination was performed in 16 children conditioned with total body irradiation (TBI) and cyclophosphamide (CY) prior to bone marrow transplantation (BMT), and in 52 children treated with multiagent chemotherapy. For each child, three age- and sex-matched healthy controls were selected. Evaluation of disturbances in dental development and tooth size was based on planimetric measurements of mandibular teeth on panoramic radiographs. Short V-shaped roots were diagnosed in 94 per cent of the children treated with TBI/CY compared with 19 per cent in the chemotherapy group (P < 0.001). Children receiving TBI/CY also exhibited a pronounced reduction in tooth size compared with the controls. Reductions varied from 19 per cent in incisors to 39 per cent in the second molars. In the chemotherapy group the corresponding values were 7 and 15 per cent respectively. When comparing crown/root ratios, the indices for incisors, canines (P < 0.05) and molars (P < 0.01) in the BMT group were significantly higher than the corresponding values in the control group. This indicates that the reduction in root size was more pronounced than the reduction in crown size. The premolars in the BMT group exhibited a similar reduction in crown and root size. All developing teeth were affected by multiagent chemotherapy and radiation therapy. The most severe disturbances were found in children treated with TBI/CY at a young age.
Näsman
M
M
Department of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Stockholm, Sweden.
Forsberg
C M
CM
Dahllöf
G
G
D000367:Age Factors; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001641:Bicuspid / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D016026:Bone Marrow Transplantation; D016022:Case-Control Studies; D002648:Child; D003481:Cuspid / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D008297:Male; D008334:Mandible; D008963:Molar / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D009805:Odontogenesis / Q000187:drug effects / Q000528:radiation effects; D009811:Odontometry; D011862:Radiography, Panoramic; D019228:Tooth Crown / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D014092:Tooth Root / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D014916:Whole-Body Irradiation
D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide