1
|
Pombo Lopes J, Rodrigues I, Machado V, Botelho J, Bandeira Lopes L. Chemotherapy and Radiotherapy Long-Term Adverse Effects on Oral Health of Childhood Cancer Survivors: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 16:110. [PMID: 38201538 PMCID: PMC10777916 DOI: 10.3390/cancers16010110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
The survival rate for pediatric cancer has increased over the past few decades, short- and long-term complications have been detected and studied, and oral complications have emerged as an important topic of research. Here, we aimed to highlight the importance of oral manifestations that may only become apparent years or even decades after cancer treatment. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched articles using PubMed via the MEDLINE, Web of Science, and LILACS databases until October 2023. Overall, 35 observational studies were included, and the results estimated a pooled prevalence of the following dental anomalies: discoloration, 53%; crown-root malformations and agenesis, 36%; enamel hypoplasia, 32%; root development alterations, 29%; unerupted teeth, 24%; microdontia, 16%; hypodontia, 13%; and macrodontia, 7%. Most childhood cancer survivors have at least one dental sequela. Childhood cancer survivors presented a higher risk of having dental alterations than control counterparts. Additional analyses reveal possible sex-based differences that should be explored in future studies. These results collectively highlight the importance of oral healthcare and the prevention of disease in childhood cancer survivors.
Collapse
Affiliation(s)
- Joana Pombo Lopes
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (J.P.L.); (I.R.); (V.M.); (J.B.)
| | - Inês Rodrigues
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (J.P.L.); (I.R.); (V.M.); (J.B.)
| | - Vanessa Machado
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (J.P.L.); (I.R.); (V.M.); (J.B.)
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - João Botelho
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (J.P.L.); (I.R.); (V.M.); (J.B.)
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Luísa Bandeira Lopes
- Clinical Research Unit, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (J.P.L.); (I.R.); (V.M.); (J.B.)
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| |
Collapse
|
2
|
Dental caries and dental developmental defects as adverse effects of antineoplastic treatment in childhood cancer survivors. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00789-z. [PMID: 36906732 DOI: 10.1007/s40368-023-00789-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023]
Abstract
PURPOSE To evaluate the prevalence of dental caries and dental developmental defects (DDD) in childhood cancer survivors (CCS) and identify disease and treatment-related risk factors. METHODS CCS aged up to 21 years, diagnosed with a malignancy before the age of 10 years and in remission for at least one year were included. Data were collected from patients' medical records and through a clinical examination where presence of dental caries and prevalence of DDD were recorded. Fisher's exact test was used to assess possible correlations and multivariate regression analysis to determine risk factors for defect development. RESULTS Seventy CCS with a mean chronological age of 11.2 years at the time of examination, mean age at cancer diagnosis of 4.17 years, and a mean post-treatment follow-up time of 5.48 years were included. Mean DMFT/dmft was 1.31, with 29% of survivors presenting with at least one carious lesion. Younger patients on the day of examination and patients treated with higher radiation dose, showed significantly higher prevalence of dental caries. The prevalence of DDD was 59%, with demarcated opacities being the defect most commonly observed (40%). Age at dental examination, diagnosis, age at diagnosis, and time that have elapsed since the end of treatment were the factors significantly affecting its prevalence. Regression analysis revealed that age at examination was the only factor significantly associated with the presence of coronal defects. CONCLUSION A great number of CCS presented with at least one carious lesion or a DDD, with the prevalence being significantly associated with various disease-specific characteristics, but age at dental examination the only significant predictor.
Collapse
|
3
|
The prevalence of dental developmental anomalies among childhood cancer survivors according to types of anticancer treatment. Sci Rep 2022; 12:4485. [PMID: 35296697 PMCID: PMC8927608 DOI: 10.1038/s41598-022-08266-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 03/02/2022] [Indexed: 11/08/2022] Open
Abstract
Survival following childhood cancer has increased considerably. In an observational cross-sectional study, we assessed the prevalence of dental developmental anomalies (DDA) among childhood cancer survivors according to types of anticancer treatment. Permanent teeth were examined clinically and radiographically in 121 adolescents with a history of childhood malignancies, to identify DDA, namely hypomineralization or hypoplasia, microdontia, root changes and hypodontia. DDA were observed in 56/121 individuals (46%), in 309/3388 teeth (9%). Hypomineralization or hypoplasia of enamel appeared in 21 (17%) patients. Altered root development appeared in 26 patients and hypodontia affected 13 (10%). Dental anomalies were observed in 36 (43%) individuals who received chemotherapy and not radiation, in 20 (52%) who received radiotherapy, and in 15 (60%) of those who received head and neck radiotherapy. Among patients who received only chemotherapy, young age (6 years or younger) was associated with a higher number of malformed teeth. In conclusion, antineoplastic treatment that combines chemotherapy and radiotherapy appears to increase the risk of DDA. Radiation to the head and neck area was shown to particularly increase the risk of DDA. No specific chemotherapy agent was found to be associated more than the others with DDA.
Collapse
|
4
|
Seremidi K, Kavvadia K, Kattamis A, Polychronopoulou A. Dental late effects of antineoplastic treatment on childhood cancer survivors: Radiographic findings. Int J Paediatr Dent 2021; 31:742-751. [PMID: 33759247 DOI: 10.1111/ipd.12792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/25/2021] [Accepted: 03/22/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Dental anomalies are common late side effects of childhood cancer therapy and may lead to anatomical, functional, and aesthetic sequelae. AIM The study aimed to record dental late effects of antineoplastic treatment and associate them with disease and treatment characteristics in order to identify possible risk factors. DESIGN Orthopantomograms of 70 survivors aged 4-21 years, who were treated at ages 0-10 years for any type of malignancy and completed antineoplastic treatment at least one year before, were examined. Incidence of developmental disturbances was recorded. Their severity was calculated, and odds ratios for the development of severe defects were estimated. RESULTS Root defects presented in 62% of the participants, with impaired root growth being the most common (58%). Increased incidence was associated with combination treatment protocols, irradiation to the head and neck region, and administration of antimetabolites, steroids, and vincristine. Mean DeI value was 17.46 with risk factors for the development of severe root defects being diagnosis of acute lymphoblastic leukemia, combination treatment protocols, administration of cyclophosphamide and steroids, and hemopoietic stem cell transplantation. CONCLUSIONS Root defects are common among childhood cancer survivors, with their incidence and severity being affected by multiple disease and treatment characteristics.
Collapse
Affiliation(s)
- Kyriaki Seremidi
- Department of Pediatric Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Kavvadia
- Division of Pediatric Dentistry, Department of Comprehensive Dentistry, University of Louisville, Louisville, KY, USA
| | - Antonis Kattamis
- Division of Pediatric Haematology-Oncology, First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Argyro Polychronopoulou
- Department of Preventive and Community Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
5
|
Seremidi K, Kloukos D, Polychronopoulou A, Kattamis A, Kavvadia K. Late effects of chemo and radiation treatment on dental structures of childhood cancer survivors. A systematic review and meta-analysis. Head Neck 2019; 41:3422-3433. [PMID: 31228308 DOI: 10.1002/hed.25840] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/17/2019] [Accepted: 06/04/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND This systematic review summarizes the prevalence of dental defects after chemo and radiation therapy and correlates the findings with specific characteristics of each treatment modality. METHODS Database search was performed for studies reporting dental late effects of chemo and radiation therapy. After data extraction and risk of bias assessment, prevalence of crown and root defects was assessed. Correlations between each defect and the characteristics of the antineoplastic treatment were performed. RESULTS Sixteen nonrandomized studies were included, yielding a total of 1300 patients with a mean age at diagnosis of 4.5 years. Results reported that root defects were more common than crown defects. The most common root defect was impaired root growth and microdontia the most common crown defect. Age, radiation dose and field were statistically associated with higher prevalence of dental defects. CONCLUSION Defects were associated with combination of chemotherapy and radiotherapy, as used in current therapeutic antineoplastic modalities.
Collapse
Affiliation(s)
- Kyriaki Seremidi
- Department of Paediatric Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics, 251 Greek Air Force Hospital, Athens, Greece.,Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Argy Polychronopoulou
- Department of Preventive and Community Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Kattamis
- Division of Paediatric Haematology-Oncology, First Department of Paediatrics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Kavvadia
- Department of Comprehensive Dentistry, Division of Pediatric Dentistry, University of Louisville, Louisville, Kentucky
| |
Collapse
|
6
|
Abstract
One of many possible complications of cancer therapy in children is enamel demineralization and such changes in the ion content of dental hard tissues may increase susceptibility to caries. The study aims to assess the prevalence of dental caries among childhood cancer survivors.A cross-sectional study was conducted on 225 children aged between 4 and 18 years, including 75 cancer patients and 150 sex- and age-matched controls. The cancer survivors were recruited from single pediatric oncology center. The control group was formed from students of randomly selected kindergartens and schools. Dental investigation was held between July 2013 and January 2016, approximately 5 years after the cessation of anticancer treatment (range: 6-155 months). The occurrence of dental caries was assessed with DMF/dmf index (showing the mean number of decayed, missing and filled permanent/deciduous teeth). Univariate statistical approach was performed and P-values < .05 were considered as statistically significant.The frequency of dental caries was comparable in both groups (85.4% vs 84%). However, the DMF index was higher in cancer patients than in controls: the median and interquartile ranges were 2 (0-4) vs 0 (0-2); P < .01. This correlates with duration of anticancer therapy (r = 0.26; P < .05). Moreover, children who had radiotherapy of the head and neck regions had significantly higher DMF scores than the ones who did not: 4.5 (1-6) vs 2 (0-4); P < .05. Socioeconomic and education status within family also has a significant impact on DMF scores in the cancer group. In conclusion, cancer patients, particularly those with a poor social background, should receive professional dental care as their caries process is more active than that of healthy peers.
Collapse
Affiliation(s)
| | | | | | - Małgorzata Zubowska
- Departments of Pediatrics, Oncology and Hematology, Medical University of Lodz, Poland
| | - Wojciech Fendler
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Departments of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Wojciech Młynarski
- Departments of Pediatrics, Oncology and Hematology, Medical University of Lodz, Poland
| |
Collapse
|
7
|
Oral and dental alterations and growth disruption following chemotherapy in long-term survivors of childhood malignancies. Support Care Cancer 2018; 27:1891-1899. [DOI: 10.1007/s00520-018-4454-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 08/30/2018] [Indexed: 11/30/2022]
|
8
|
Busenhart DM, Erb J, Rigakos G, Eliades T, Papageorgiou SN. Adverse effects of chemotherapy on the teeth and surrounding tissues of children with cancer: A systematic review with meta-analysis. Oral Oncol 2018; 83:64-72. [DOI: 10.1016/j.oraloncology.2018.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 11/29/2022]
|
9
|
Gawade PL, Hudson MM, Kaste SC, Neglia JP, Constine LS, Robison LL, Ness KK. A systematic review of dental late effects in survivors of childhood cancer. Pediatr Blood Cancer 2014; 61:407-16. [PMID: 24424790 PMCID: PMC4281834 DOI: 10.1002/pbc.24842] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 10/08/2013] [Indexed: 11/10/2022]
Abstract
Survivors of childhood cancer are at risk for dental late effects. This systematic review summarizes associations between treatment exposures and dental late effects among survivors of childhood cancer. We included investigations with at least 20 study participants conducted for 2 or more years after completion of childhood, adolescent, or young adult cancer therapy. This review suggests both independent and additive effects of radiotherapy and chemotherapy on dental complications, and identifies vulnerable groups with specific host and treatment characteristics. This summary provides information that will assist clinicians to prevent, detect, and facilitate early intervention for dental late effects.
Collapse
Affiliation(s)
- Prasad L. Gawade
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN 38105
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN 38105 ,Oncology, St. Jude Children’s Research Hospital, Memphis, TN
38105
| | - Sue C. Kaste
- Oncology, St. Jude Children’s Research Hospital, Memphis, TN
38105 ,Radiological Sciences at St. Jude Children’s Research
Hospital, Memphis, TN 38105 ,Department of Radiology, College of Medicine, University of
Tennessee Health Science Center, 910 Madison, Suite 1002, Memphis, TN 38163
| | - Joseph P. Neglia
- Department of Pediatrics, University of Minnesota Medical School,
Minneapolis, MN 55455
| | - Louis S. Constine
- Departments of Radiation Oncology and Pediatrics, School of Medicine
and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 647,
Rochester, NY 14642
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN 38105
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude
Children’s Research Hospital, Memphis, TN 38105
| |
Collapse
|
10
|
Nemeth O, Hermann P, Kivovics P, Garami M. Long-term effects of chemotherapy on dental status of children cancer survivors. Pediatr Hematol Oncol 2013; 30:208-15. [PMID: 23373734 DOI: 10.3109/08880018.2013.763391] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to investigate the long-term effects of chemotherapy on the dental and gingival health and dental disturbance parameters of children cancer survivors. PROCEDURE Thirty-eight children (mean age 12.2 ± 0.5 years) who underwent chemotherapy at 4.29 ± 1.71 years of age formed the study group. Forty age- and gender-matched healthy children with a similar socioeconomic background served as controls. Subjects' caries status (number of decayed, missing, or filled permanent teeth [DMF-T]) was recorded according to World Health Organization criteria. Subjects' periodontal status was recorded according to the community periodontal index system. Radiographic dental examination was used to analyze dental malformations. RESULTS DMF-T, D-T (number of decayed permanent teeth), and F-T (number of filled permanent teeth) were significantly higher in the study group compared to the controls (4.61 ± 3.71, 3.97 ± 4.45, respectively, and 0.58 ± 0.14 vs. 2.21 ± 1.01, 0.84 ± 1.82, and 1.18 ±1.07, respectively. The most frequent dental disturbances were root malformation (52.6%) and agenesis (47.4%). CONCLUSIONS According to our examination dental status of long-term survivors is worse than in controls. Hence proper oral hygiene for children cancer survivors (CCS) is critical. In order to meet the need for dental care in CCS health authorities are encouraged to revitalize the dental services Long-term follow-up of CCS is necessary to monitor their dental growth and oral health.
Collapse
Affiliation(s)
- Orsolya Nemeth
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary.
| | | | | | | |
Collapse
|
11
|
Sheinfeld Gorin S, McAuliffe P. Implications of childhood cancer survivors in the classroom and the school. HEALTH EDUCATION 2008. [DOI: 10.1108/09654280910923363] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
12
|
Hobbie WL, Moshang T, Carlson CA, Goldmuntz E, Sacks N, Goldfarb SB, Grupp SA, Ginsberg JP. Late effects in survivors of tandem peripheral blood stem cell transplant for high-risk neuroblastoma. Pediatr Blood Cancer 2008; 51:679-83. [PMID: 18623215 PMCID: PMC2888471 DOI: 10.1002/pbc.21683] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Increasing numbers of children with advanced neuroblastoma are achieving cure. We describe the clinical late effects specific to survivors of stage IV neuroblastoma all similarly treated using tandem autologous peripheral blood stem cell rescue with TBI. METHOD The medical records of 35 neuroblastoma patients treated at CHOP between 1997 and 2001 were examined. Eighteen of the 35 patients died of progressive disease, and 4 were lost to follow-up. Thirteen patients continue to follow-up in our Multidisciplinary Cancer Survivorship Clinic where they are evaluated and monitored by a consistent group of subspecialists that evaluate long-term sequelae. Data on treatment exposures including TBI and treatment related sequelae identified by clinician assessment and/or diagnostic testing were collected. RESULTS Results indicate late effects were present in all 13 subjects, 12 of whom suffered from multiple negative sequelae, including issues with growth hormone deficiency, dental problems, osteochondromas and hearing deficiencies, among others, most at higher rates than reported previously. CONCLUSIONS The findings in this small cohort indicate the need for future prospective studies of this intensive pediatric cancer treatment, and underscore the importance of medical intervention and long-term monitoring of these at-risk subjects to increase overall quality-of-life.
Collapse
Affiliation(s)
- Wendy L Hobbie
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Gonçalves MIR, Radzinsky TC, da Silva NS, Chiari BM, Consonni D. Speech-language and hearing complaints of children and adolescents with brain tumors. Pediatr Blood Cancer 2008; 50:706-8. [PMID: 17534932 DOI: 10.1002/pbc.21209] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Central nervous system (CNS) tumors generally leave sequelae that may compromise speech, language, swallowing, hearing, and voice functions. This report describes the incidence of speech-language and hearing complaints and disorders in children and adolescents with CNS tumor under treatment at one of the most important Brazilian reference center for pediatric cancer. One-hundred ninety patients were examined for speech-pathology screening and analysis: forty-two percent presented with complaints and symptoms. From the remaining patients, 68% presented clinical symptoms and 32% were actually free from any speech-language and hearing-related symptoms. The high incidence of complaints and symptoms indicate that these patients might benefit from specific rehabilitation interventions.
Collapse
|
14
|
Abstract
This article is divided into three time periods according to the different phases of cancer treatment: pre, inter, and postcancer therapy. The purpose of dental protocols prior to cancer therapy and the incidence and management of acute and long term oral complications from cancer therapy in the pediatric population are discussed.
Collapse
Affiliation(s)
- Catherine H Hong
- Department of Oral Medicine, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28232-2861, USA.
| | | |
Collapse
|
15
|
Avşar A, Elli M, Darka O, Pinarli G. Long-term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors. ACTA ACUST UNITED AC 2007; 104:781-9. [PMID: 17618135 DOI: 10.1016/j.tripleo.2007.02.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Revised: 12/07/2006] [Accepted: 02/22/2007] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the long-term effects of chemotherapy on oral health and dental development in childhood cancer survivors (CCS). STUDY DESIGN Ninety-six CCS patients with a mean age of 10.8 years and 96 healthy children of the same age and sex and social background composed the study group. The caries experience of the children was recorded according to the criteria of the World Health Organization, and plaque-gingival status was evaluated according to the Silness-Loe Index. The children were also investigated for stimulated salivary flow rate, buffer capacity, salivary mutans streptococci, and lactobacilli. Disturbances of enamel mineralization were recorded according to the index of developmental defects in dental enamel. Dental development disturbances were diagnosed on panoramic radiographs. RESULTS The caries experience, mutans streptococci, and lactobacilli colonization in CCS children were found significantly higher than in the healthy subjects (P < .05). White/cream colored opacities were the most frequent enamel mineralization disturbances (69.8 %). The occurrence of arrested root development with short V-shaped root malformation was significantly higher in CCS children than in the healthy subjects (P < .05). No statistically significant difference was found between group <or=5 years and >5 years. CONCLUSION This current investigation has shown that CCS children are at an increased risk of caries and developmental dental disturbances.
Collapse
Affiliation(s)
- Aysun Avşar
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Ondokuz Mayis, Samsun, Turkey.
| | | | | | | |
Collapse
|
16
|
Abstract
In this article the difficulties that face survivors of childhood cancer therapy are presented, and the late effects of such therapy, separated into nonmalignant and malignant late effects, are discussed according to organ system. Recommendations for monitoring the late effects are set forth. A table listing radiation-therapy site and chemotherapeutic agents and selected late effects that result from their use is provided. Finally, a brief recommendation regarding the establishment of a late-effects clinic is also presented.
Collapse
Affiliation(s)
- Joseph D Dickerman
- University of Vermont College of Medicine, Department of Pediatrics, 89 Beaumont Ave, Given D201, Burlington, VT 05405-0068, USA.
| |
Collapse
|