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Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children

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Abstract

Purpose

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.

Materials and 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.

Main 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.

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Acknowledgments

We like to acknowledge the help of Ms I. C. M. van Gils and the staff of the Departments of Oral and Maxillofacial Surgery and Radiology, Leiden University Medical Center.

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Correspondence to J. E. Raber-Durlacher.

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van der Pas-van Voskuilen, I.G.M., Veerkamp, J.S.J., Raber-Durlacher, J.E. et al. Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children. Support Care Cancer 17, 1169–1175 (2009). https://doi.org/10.1007/s00520-008-0567-1

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