Long-term effects of bone marrow transplantation on dental status in children with leukaemia.
Minimal data about oral and dental health in long-term survivors after BMT are available. We studied the dental status of 27 children (19 males, eight females) with leukaemia, followed up with a routine oral examination, panoramic tomogram and, when necessary, an endoral radiograph at a median of 2 years (range 1-10) after BMT. Community periodontal index treatment necessity (CPITN), dental caries, missing or filled permanent teeth (DMFT) and dento-facial alterations according to WHO criteria were registered and evaluated. Median age of the patients at BMT was 9 years (range 1.1-17.9). The mean DMFT score ranged from 1.6 to 12.4 according to age at examination and was slightly higher than that which we previously reported in children who received chemotherapy alone. CPITN showed the presence of soft deposits in 77.7%, serious gingivitis in 59.2% and parodontal involvement in 3.7% of cases. Dento-facial abnormalities were found in 55.5% of patients, while 62.9% of the patients had tooth abnormalities or agenesis. Nine out of 27 patients (33%) had root hypoplasia. A negative impact on DMFT index due to multiple post-BMT factors was found. Age is the crucial factor in determining a developmental defect of enamel and root. The follow-up of long-term survivors after BMT should include regular dental examination.
Uderzo
C
C
Clinica Pediatrica dell'Università di Milano, Ospedale S Gerardo, Monza, Milan, Italy.
Fraschini
D
D
Balduzzi
A
A
Galimberti
S
S
Arrigo
C
C
Biagi
E
E
Pignanelli
M
M
Nicolini
B
B
Rovelli
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology / Q000209:etiology; D019229:Dentition, Permanent; D005147:Facial Bones / Q000473:pathology / Q000528:radiation effects; D005260:Female; D005891:Gingivitis / Q000453:epidemiology / Q000209:etiology; D006086:Graft vs Host Disease / Q000150:complications; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000150:complications* / Q000628:therapy; D008297:Male; D009805:Odontogenesis / Q000528:radiation effects; D010510:Periodontal Diseases / Q000453:epidemiology / Q000209:etiology; D010512:Periodontal Index; D010518:Periodontitis / Q000453:epidemiology / Q000209:etiology; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D009057:Stomatognathic Diseases / Q000453:epidemiology / Q000209:etiology*; D017741:Survivors; D014071:Tooth Abnormalities / Q000453:epidemiology / Q000209:etiology; D014092:Tooth Root / Q000187:drug effects / Q000528:radiation effects; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014916:Whole-Body Irradiation / Q000009:adverse effects