title: Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children.
abstract: OBJECTIVE
  The purpose of this study was to assess late effects of cytotoxic therapy with hematopoietic stem cell transplantation (HCT) on dental development in survivors of childhood cancer.
  
  
  METHODS
  Forty children who underwent allogeneic HCT for a variety of hematological malignancies were evaluated at a minimum of 2 years after transplantation. We obtained information on oral symptoms, exposed panoramic radiographs (PRG), and performed an oral examination. PRGs were scored for agenesis and root and/or crown abnormalities. The root-crown ratio was calculated, and dental age was assessed using Demirjian' s method.
  
  
  RESULTS
  The studied group showed a significantly higher prevalence of tooth agenesis compared to normative data for first and second premolars in both the maxilla and mandible, as well as the second molars in the mandible (all p values <0.001). Children who were <3 years old at the time of cancer treatment had significantly more missing teeth than older children, F(2,37) = 7.58, p < 0.002. Root-crown ratios were lower in the study sample than those from normative data. In addition, the mean dental age was higher (as a result of earlier apical root closure) than the mean chronological age, t(28) = 2.47, p < 0.020.
  
  
  CONCLUSIONS
  Nearly all children examined had dental development disturbances, including agenesis, short roots, and arrested root development. An oral/dental evaluation and preventative oral supportive care regimens should be part of programs monitoring late effects in long-term survivors of childhood cancer.
authors.affiliation: Department of Pedodontology, Academic Centre of Dentistry Amsterdam, Amsterdam, The Netherlands.
authors.forename: I G M
authors.initials: IG
authors.lastname: van der Pas-van Voskuilen
authors.forename: J S J
authors.initials: JS
authors.lastname: Veerkamp
authors.forename: J E
authors.initials: JE
authors.lastname: Raber-Durlacher
authors.forename: D
authors.initials: D
authors.lastname: Bresters
authors.forename: A J
authors.initials: AJ
authors.lastname: van Wijk
authors.forename: A
authors.initials: A
authors.lastname: Barasch
authors.forename: S
authors.initials: S
authors.lastname: McNeal
authors.forename: R A Th
authors.initials: RA
authors.lastname: Gortzak
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003603:Cytotoxins / Q000009:adverse effects; D005260:Female; D005387:Finland; D019337:Hematologic Neoplasms / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D014070:Tooth / Q000187:drug effects* / Q000254:growth & development
chemical_list: D003603:Cytotoxins