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Habib S, Fatima B, Khan FR. Generalized root agenesis in permanent dentition of a young adolescent patient with rhabdomyosarcoma: a case report. BMC Oral Health 2024; 24:961. [PMID: 39154167 PMCID: PMC11330129 DOI: 10.1186/s12903-024-04709-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Parameningeal rhabdomyosarcoma (PM-RMS) is a rare and aggressive soft tissue malignancy that primarily occurs in the head and neck region. The standard treatment approach for RMS involves a multimodal therapy regimen, which includes surgery, chemotherapy, and radiotherapy. However, the routine use of radiotherapy and chemotherapy in young patients with RMS in the head and neck region can lead to adverse effects on dental development and thereby, pose a challenge in planning dental intervention. CASE PRESENTATION This case report outlines the dental and facial developmental consequences in a 13-year-old child, who received chemo-radiotherapeutic intervention at the age of 7 years for the management of PM-RMS. Following treatment, the child exhibited significant dental complications, including arrested root growth and restricted mouth opening. CONCLUSIONS This case highlights the necessity for interdisciplinary collaboration between oncologists, dentists, and other healthcare professionals to mitigate the adverse effects on dental health and overall quality of life in patients undergoing chemo-radiotherapy for rhabdomyosarcoma.
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Affiliation(s)
- Saqib Habib
- Executive Dentistry Clinics Rehman Medical Institute, Peshawar, Pakistan
| | - Bibi Fatima
- Operative Dentistry & Endodontics, Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan.
| | - Farhan Raza Khan
- Operative Dentistry & Endodontics, Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
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Al-Ansari S, Stolze J, Bresters D, Brook AH, Laheij AMGA, Brand HS, Dahllöf G, Rozema FR, Raber-Durlacher JE. Late Complications in Long-Term Childhood Cancer Survivors: What the Oral Health Professional Needs to Know. Dent J (Basel) 2024; 12:17. [PMID: 38275678 PMCID: PMC10813876 DOI: 10.3390/dj12010017] [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: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 01/27/2024] Open
Abstract
With diagnostic and therapeutic advances, over 80% of children diagnosed with cancer become long-term survivors. As the number of childhood cancer survivors (CCS) continues to increase, dental practitioners become more likely to have CCS among their patients. CCS may develop late complications from damage caused by their cancer treatment to endocrine, cardiovascular, musculoskeletal, and other organ systems. These complications may surface decades after the completion of treatment. Adverse outcomes of childhood cancer treatment frequently involve oral and craniofacial structures including the dentition. Tooth development, salivary gland function, craniofacial growth, and temporomandibular joint function may be disturbed, increasing oral health risks in these individuals. Moreover, CCS are at risk of developing subsequent malignancies, which may manifest in or near the oral cavity. It is important that dental practitioners are aware of the childhood cancer history of their patients and have knowledge of potential late complications. Therefore, this narrative review aims to inform dental practitioners of late oral complications of cancer treatment modalities commonly used in pediatric oncology. Furthermore, selected common non-oral late sequelae of cancer therapy that could have an impact on oral health and on delivering dental care will be discussed.
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Affiliation(s)
- Sali Al-Ansari
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Department Maxillofacial Surgery, Fachklinik Horneide, 48157 Münster, Germany
| | - Juliette Stolze
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (J.S.); (H.S.B.)
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
- Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
| | - Alan Henry Brook
- Adelaide Dental School, University of Adelaide, Adelaide 5005, Australia;
- Institute of Dentistry, Queen Mary University of London, London E12AD, UK
| | - Alexa M. G. A. Laheij
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Henk S. Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (J.S.); (H.S.B.)
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, 14152 Huddinge, Sweden;
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), 100098 Trondheim, Norway
| | - Frederik R. Rozema
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Judith E. Raber-Durlacher
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
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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.
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Presentation of a Case of Short Root Anomaly in an 11-Year-Old Child. Case Rep Dent 2023; 2023:1766133. [PMID: 36643592 PMCID: PMC9833915 DOI: 10.1155/2023/1766133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Short root anomaly (SRA) is a developmental anomaly in which the affected teeth present morphologically normal crowns and short, round roots. The exact cause of SRA is unknown. A case of an 11-year-old female patient with SRA is described. The patient presented short, round roots of all permanent teeth but first molars. Maxillary lateral incisors presented severe root resorption and mobility. Treatment plan included preservation of the maxillary lateral incisors by splinting them to their adjacent teeth using a stainless steel coaxial wire. A custom mouthguard for dental trauma protection was also constructed using a computer-aided design - computer-aided manufacturing (CAD-CAM) system in order to fabricate 3D-printed dental casts. At 2-year follow-up, the mobility of maxillary lateral incisors decreased, and the patient's dentition remained stable. Considerations regarding differential diagnosis, orthodontic management, and treatment options after an eventual loss of teeth are thoroughly discussed.
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Bousserouit M, Benjelloune L, Chbicheb S. Late dental effects in children submitted to chemotherapy: A case report. Ann Med Surg (Lond) 2022; 84:104845. [PMID: 36582914 PMCID: PMC9793133 DOI: 10.1016/j.amsu.2022.104845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 11/21/2022] Open
Abstract
Chemotherapy may have many effects on teeth such a microdontia, hypoplasia and V shaped roots. The incidence and severity of dental abnormalities depend on the age at the diagnosis, the type of chemotherapeutic agent used. Therefore, it is important that general and pediatric dentists be aware of the late adverse effects of cancer therapy in children, especially in the oral cavity. This article intends to document a case illustrating different dental anomalies secondary to chemotherapy in 20 years old boy who had a history of chemotherapy in childhood.
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Affiliation(s)
- M. Bousserouit
- Oral Surgery Resident, Oral Surgery Department, Faculty of Dental Medicine-Rabat, Mohammed V University of Rabat, Morocco,Corresponding author. Faculty of dentistry, BP 6212, Madinat Al Irfane, Rabat, Morocco.
| | - L. Benjelloune
- Oral Surgery Department, Faculty of Dental Medicine-Rabat, Mohammed V University of Rabat, Morocco
| | - S. Chbicheb
- Oral Surgery Department, Faculty of Dental Medicine-Rabat, Mohammed V University of Rabat, Morocco
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A Long-Term Follow-Up of Dental and Craniofacial Disturbances after Cancer Therapy in a Pediatric Rhabdomyosarcoma Patient: Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212158. [PMID: 34831922 PMCID: PMC8621981 DOI: 10.3390/ijerph182212158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022]
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents. A boy aged seven years and five months was diagnosed with stage three group III embryonal parameningeal RMS with intracranial extension. He received chemotherapy for 23 weeks in combination with localized radiotherapy during the inductive phase of nine weeks (a total tumor dose of 5040 cGy). Three months later, he was referred to the department of pediatric dentistry for radiation-induced caries, the treatment of which was later terminated because of severe trismus and radiation-induced oropharyngeal mucositis. Three years later, the patient returned for the fitting of a prosthesis because of mastication problems. The dental treatments performed included: extraction, banding, composite resin restorations, root canal fillings, and stainless steel crown fabrication. An interim denture was fitted due to the poor retention of the fixed prosthesis. As the patient grew older, they developed facial asymmetry as a result of the prominent atrophy of their right cheek. By the age of 32, they had lost multiple teeth and exhibited severe facial deformity. Therefore, it is essential not only to involve a multidisciplinary medical team before, during, and after cancer therapy, but also to initiate long-term follow-ups given the potential effects of late sequelae after chemoradiation in multiple developmental areas.
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Long-Term Effects of Childhood Cancer Treatment on Dentition and Oral Health: A Dentist Survey Study from the DCCSS LATER 2 Study. Cancers (Basel) 2021; 13:cancers13215264. [PMID: 34771429 PMCID: PMC8582458 DOI: 10.3390/cancers13215264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/16/2021] [Accepted: 10/16/2021] [Indexed: 11/21/2022] Open
Abstract
Simple Summary We aimed to identify the prevalence of and independent risk factors for dental and oral problems in childhood cancer survivors (CCSs). This cross-sectional study is part of the Dutch Childhood Cancer Survivor Study (DCCSS) LATER 2. Our study included survey data on 154 CCSs, on whom information from dentists on oral health data was received (71.3%). In total, 36.3% of survivors were reported to have at least one dental developmental disorder (DDD). The most prevalent DDDs were short-root anomaly (14.6%), agenesis (14.3%), and microdontia (13.6%). Risk factors for at least one DDD were younger age at diagnosis (<3 years vs. 5+ years) and dose-dependent alkylating agent therapy. This study provides more insight into risk factors for oral health problems in Dutch CCSs. This information is essential in order to improve early detection, prevention, and dental care of oral health problems in CCSs. Abstract Objectives: The aim of this study was to identify the prevalence of and independent risk factors for long-term effects of childhood cancer treatment on the dentition and oral health in childhood cancer survivors (CCSs). Methods: This cross-sectional study is part of the Dutch Childhood Cancer Survivor Study (DCCSS) LATER 2. CCSs were diagnosed with cancer between 1963 and 2001. This study focuses on survey data of 154 CCSs on whom information about their oral health was received from their dentists (71.3%). Descriptive statistics and univariable and multivariable Poisson regression analyses were performed to determine the association between treatment characteristics and oral health data. Results: Of the study group, 36.3% had at least one DDD. The most prevalent DDDs were short-root anomaly (14.6%), agenesis (14.3%), and microdontia (13.6%). Risk factors for at least one DDD were younger age at diagnosis (<3 years) and dose-dependent alkylating agent therapy. Conclusions: This study provides more insight into risk factors for oral health problems in Dutch CCSs. This information is essential in order to improve early detection, prevention, dental care, and quality of life. Further studies are needed in order to better define dose-related radiotherapy exposure of the developing teeth in correlation with oral health problems.
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Proc P, Szczepańska J, Zubowska M, Zalewska-Szewczyk B, Młynarski W. The Broad Variability in Dental Age Observed among Childhood Survivors Is Cancer Specific. Cancer Res Treat 2020; 53:252-260. [PMID: 32854493 PMCID: PMC7812002 DOI: 10.4143/crt.2020.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 08/22/2020] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The study aimed to assess the differences in dental maturation between childhood cancer survivors and healthy children. Materials and Methods Fifty-nine cancer patients including 16 (27.1%) girls and 43 (72.8%) boys, aged between 4 and 16 years, underwent dental and radiographic examinations. The mean duration of anticancer therapy was 16.8 months (range, 1 to 47 months), and 4.6 years (range, 8 to 123 months) had passed since the termination of disease. The control group consisted of 177 panoramic radiographs of age- and sex-matched healthy individuals. Dental age (DA) was estimated with Demirjian's scale and delta age, i.e., DA-chronological age (CA), was used to compare groups. RESULTS The DA of cancer survivors was accelerated by almost 1 year compared to their CA (9.9±3.1 vs. 8.9±2.8, p=0.040). The greatest difference was observed among patients with brain tumor: delta (DA-CA) was 2.2±1.1 years. Among all cancer patients, only children with familial adenomatous polyposis (FAP)-associated hepatoblastoma (HP) demonstrated delayed DA, with regard to both other cancer survivors (p=0.011) and healthy patients (p=0.037). All four patients with HP suffered from FAP, and three of them had documented adenomatous polyposis coli (APC) genes mutation. The DA of cancer patients having teeth with short roots was significantly greater than that of the cancer survivors without this anomaly (12.8±3.2 vs. 9.0±2.4, p < 0.001). CONCLUSION DA in children may be altered by cancer disease.
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Affiliation(s)
- Patrycja Proc
- Department of Pediatric Dentistry, Medical University of Lodz, Lodz, Poland
| | - Joanna Szczepańska
- Department of Pediatric Dentistry, Medical University of Lodz, Lodz, Poland
| | - Małgorzata Zubowska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
| | | | - Wojciech Młynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
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Arai K. Tooth agenesis patterns in Japanese orthodontic patients with nonsyndromic oligodontia. Am J Orthod Dentofacial Orthop 2019; 156:238-247. [DOI: 10.1016/j.ajodo.2018.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 12/31/2022]
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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.
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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
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Hernandez M, Pochon C, Chastagner P, Droz D. Long-term Adverse Effects of Acute Myeloid Leukemia Treatment on Odontogenesis in a Child. Int J Clin Pediatr Dent 2019; 12:243-246. [PMID: 31708623 PMCID: PMC6811937 DOI: 10.5005/jp-journals-10005-1614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Several studies showed that cancer therapies during tooth development are associated with dental abnormalities, including enamel defects, arrested tooth development, microdontic teeth, and agenesis. Study design We describe the case of a nine-year-old boy treated for acute myeloid leukemia at 15 months of age, who presents several dental abnormalities resulting from anticancer treatment. Results The patient was included and treated according to the ELAM 02 French protocol. Six years after allogenic hematopoietic stem cell transplantation, the intraoral and radiographic examination highlighted the agenesis of the second permanent molars and three of the four second premolars, microdontia of the first premolars, root stunting of the central incisors and first premolars, rootlessness of the first permanent molars, and enamel defects localized at the permanent incisors and canines. As a first step to reduce enamel defects, restorations with resin composite (Tetric EvoCeram® A2, Ivoclar Vivadent) were performed under a dental dam. Orthodontic treatment was contraindicated due to arrested tooth development, short roots, and a risk of resorption is considered too important. Conclusion The young age at diagnosis (<5 years of age) and intensive chemotherapy (especially myeloablative conditioning with high doses of cyclophosphamide and Busulfan) could explain the severity of the dental abnormalities. This case illustrates the importance of systematically scheduling a dental follow-up in parallel with the onco-hematologic follow-up allowing the clinicians to prevent, detect, and propose early intervention for dental late effects. How to cite this article Hernandez M, Pochon C, et al. Long-term Adverse Effects of Acute Myeloid Leukemia Treatment on Odontogenesis in a Child. Int J Clin Pediatr Dent 2019;12(3):243–246.
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Affiliation(s)
- Magali Hernandez
- Pediatric Dentistry Department, Children Hospital, CHRU Nancy, France; Pediatric Dental Department, Faculty of Dentistry, Nancy, France
| | - Cécile Pochon
- Hematology, Oncology Department, Children Hospital, CHRU Nancy, France
| | - Pascal Chastagner
- Hematology, Oncology Department, Children Hospital, CHRU Nancy, France
| | - Dominique Droz
- Pediatric Dentistry Department, Children Hospital, CHRU Nancy, France; Pediatric Dental Department, Faculty of Dentistry, Nancy, France
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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]
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Impact of Hematopoietic Stem Cell Transplantation on Dental Development. Biol Blood Marrow Transplant 2018; 25:107-113. [PMID: 30189246 DOI: 10.1016/j.bbmt.2018.08.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 08/28/2018] [Indexed: 11/23/2022]
Abstract
To investigate dental development in patients treated with a hematopoietic stem cell transplantation (HSCT), 42 children and young adults who were under 12 years old at time of HSCT were examined for dental agenesis, microdontia, and root-to-crown ratio. Conditioning regimens were total body irradiation (TBI) based in 12 patients, busulfan based in 21 patients, and 9 patients had other chemotherapeutic agents. Sixteen patients were <3 years old, 9 patients were 3 to 6 years old, and 17 patients were 6 to 12 years old at HSCT. Prevalence of agenesis and microdontia of at least 1 permanent tooth were, respectively, 51.3% and 46.2% in the study population, and 76.3% had an aberrant root-to-crown ratio. All these results were highly different from the prevalence in the healthy population. Patients treated before the age of 3 years had more microdontia (76.9%) and agenesis (92.3%) compared with patients treated at an older age. In the subgroup of patients treated after 6 years, there was more microdontia when treated with busulfan (50%) compared with treatment with TBI (0%) (P = .044). Patients treated with HSCT had many disturbances in dental development. Age at HSCT and possibly also the conditioning regimen used had an effect on their type and prevalence. Dental follow-up should be incorporated in the multidisciplinary follow-up program of these patients.
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Al-Ansari S, Jalali R, Bronckers T, Raber-Durlacher J, Logan R, de Lange J, Rozema F. The effect of a single injection of irinotecan on the development of enamel in the Wistar rats. J Cell Mol Med 2017; 22:1501-1506. [PMID: 29285894 PMCID: PMC5824403 DOI: 10.1111/jcmm.13415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 08/23/2017] [Indexed: 11/30/2022] Open
Abstract
Cancer is the second most frequent cause of death in children. Because the prognosis for childhood malignancies has improved, attention has now focused on long-term consequences of cancer treatment. The immediate effects of chemotherapy on soft tissues have been well described; however, there is less information about long-term effects of chemotherapy on the development of dental tissues. To test the association between the effect of chemotherapy on enamel development, we examined two groups of rats: one that had received an intraperitoneal dose of 200 mg/kg of irinotecan, whereas the other (control) group had received vehicle only. Rats were killed at 6, 48 and 96 hr post-injection; the mandibles dissected out, fixed for histological evaluation and scanned for mineralization defects by Micro-CT. Our results showed structural changes in the ameloblast layer along with a significant reduction in mineralization and thickness of enamel at 96 hr after chemotherapy. These data demonstrate that irinotecan induces structural changes in forming enamel that become apparent after anticancer chemotherapy treatment.
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Affiliation(s)
- Sali Al-Ansari
- Department of Oral Medicine - Academic Centre for Dentistry, Amsterdam, the Netherlands
| | - Rozita Jalali
- Department of Oral Cell Biology - Academic Centre for Dentistry Amsterdam, Amsterdam, the Netherlands
| | - Ton Bronckers
- Oral Pathology, Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Judith Raber-Durlacher
- Department of Oral Medicine - Academic Centre for Dentistry, Amsterdam, the Netherlands.,Department of Oral and Maxillofacial Surgery - Amsterdam Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Richard Logan
- Oral Pathology, Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery - Amsterdam Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Frederik Rozema
- Department of Oral Medicine - Academic Centre for Dentistry, Amsterdam, the Netherlands.,Department of Oral and Maxillofacial Surgery - Amsterdam Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
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Elad S, Zadik Y, Yarom N. Oral Complications of Nonsurgical Cancer Therapies. Atlas Oral Maxillofac Surg Clin North Am 2017; 25:133-147. [PMID: 28778303 DOI: 10.1016/j.cxom.2017.04.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Sharon Elad
- Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Avenue, Rochester, NY 14620, USA.
| | - Yehuda Zadik
- Oral Medicine Clinic for Hematologic and Oncologic Patients, Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, PO Box 91120, Jerusalem 9112102, Israel; Department of Oral Medicine, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Military PO Box 02149, Tel Hashomer, Israel
| | - Noam Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel; Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Dental abnormalities after chemotherapy in long-term survivors of childhood acute lymphoblastic leukemia 7–40 years after diagnosis. Support Care Cancer 2015; 24:1497-506. [DOI: 10.1007/s00520-015-2940-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 09/03/2015] [Indexed: 10/23/2022]
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17
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Halperson E, Moss D, Tickotsky N, Weintraub M, Moskovitz M. Dental pulp therapy for primary teeth in children undergoing cancer therapy. Pediatr Blood Cancer 2014; 61:2297-301. [PMID: 25214367 DOI: 10.1002/pbc.25227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/29/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Childhood cancer treatment negatively affects the immune system, increasing the risk for bacteremia and septicemia. As the oral cavity is a major entry portal for pathogens into the bloodstream dental care in such children tends to be radical, favouring tooth extraction over less drastic treatments such as pulpotomy, the amputation of infected dental pulp. The present study aimed to compare pulpotomy treatment success rate in children with cancer receiving immunosuppressive therapy with that of healthy children, and investigate if unsuccessful pulpotomy treatment in oncologic patients may lead to systemic complications. PROCEDURE Twenty-six medical records of children from a paediatric oncology referral centre who had dental pulpotomy treatment (in 41 teeth) while receiving active cancer care during the years 2006-2012 were compared with records of 41 randomly selected healthy children who had undergone pulpotomy treatment (41 teeth) in the same institute during these years. Clinical and radiographic data were collected during treatments and at the end of the follow-up period (six months post dental treatment). RESULTS No statisticaly significant difference was found between pulpotomy success rate amongst the two groups. Treatments success rates in the study and control groups were 82.9% (± 5.9) and 90.2% (± 4.7), respectively. No patient in the study group suffered from sepsis from a dental origin during follow-up period. CONCLUSIONS Pulpotomy in paediatric cancer patients did not increase the risk for bacteremia or systemic complications from oral origin. We therefore recommend the re-evaluation of the current protocol for treating paediatric oncology patients.
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Affiliation(s)
- Elinor Halperson
- Department of Pediatric Dentistry, the Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel
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18
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Carrillo CM, Corrêa FNP, Lopes NNF, Fava M, Odone Filho V. Dental anomalies in children submitted to antineoplastic therapy. Clinics (Sao Paulo) 2014; 69:433-7. [PMID: 24964309 PMCID: PMC4050327 DOI: 10.6061/clinics/2014(06)11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 11/26/2013] [Indexed: 11/18/2022] Open
Abstract
Cancer is the third most frequent cause of death in children in Brazil. Early diagnosis and medical advances have significantly improved treatment outcomes, which has resulted in higher survival rates and the management of late side effects has become increasingly important in caring for these patients. Dental abnormalities are commonly observed as late effects of antineoplastic therapy in the oral cavity. The incidence and severity of the dental abnormalities depend on the child's age at diagnosis and the type of chemotherapeutic agent used, as well as the irradiation dose and area. The treatment duration and aggressivity should also be considered. Disturbances in dental development are characterized by changes in shape, number and root development. Enamel anomalies, such as discoloration, opacities and hypoplasia are also observed in these patients. When severe, these abnormalities can cause functional and esthetic sequelae that have an impact on the children's and adolescents' quality of life. General dentists and pediatric dentists should understand these dental abnormalities and how to identify them aiming for early diagnosis and appropriate treatment.
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Affiliation(s)
- Camila Merida Carrillo
- Hemato-oncology Service, Dentistry Department, Instituto da Criança ITACI, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Nilza Nelly Fontana Lopes
- Pediatric Oncology Institute, GRAACC-IOP, Department of Dentistry, School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Marcelo Fava
- Hemato-oncology Service, Dentistry Department, Instituto da Criança ITACI, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vicente Odone Filho
- Department of Pediatric, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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19
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Effinger KE, Migliorati CA, Hudson MM, McMullen KP, Kaste SC, Ruble K, Guilcher GMT, Shah AJ, Castellino SM. Oral and dental late effects in survivors of childhood cancer: a Children's Oncology Group report. Support Care Cancer 2014; 22:2009-19. [PMID: 24781353 PMCID: PMC4118932 DOI: 10.1007/s00520-014-2260-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 04/16/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children's Oncology Group. METHODS An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network "Categories of Consensus" system. RESULTS The Children's Oncology Group oral-dental panel selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Additionally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent malignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. CONCLUSIONS Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life.
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Affiliation(s)
- Karen E Effinger
- Division of Pediatric Hematology/Oncology/Stem Cell Transplantation, Stanford University, 1000 Welch Rd, Suite 300, Palo Alto, CA, 94304, USA,
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20
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Oral complications in hematopoietic stem cell recipients: the role of inflammation. Mediators Inflamm 2014; 2014:378281. [PMID: 24817792 PMCID: PMC4003795 DOI: 10.1155/2014/378281] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/27/2014] [Indexed: 11/30/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is widely used as a potentially curative treatment for patients with various hematological malignancies, bone marrow failure syndromes, and congenital immune deficiencies. The prevalence of oral complications in both autologous and allogeneic HSCT recipients remains high, despite advances in transplant medicine and in supportive care. Frequently encountered oral complications include mucositis, infections, oral dryness, taste changes, and graft versus host disease in allogeneic HSCT. Oral complications are associated with substantial morbidity and in some cases with increased mortality and may significantly affect quality of life, even many years after HSCT. Inflammatory processes are key in the pathobiology of most oral complications in HSCT recipients. This review article will discuss frequently encountered oral complications associated with HSCT focusing on the inflammatory pathways and inflammatory mediators involved in their pathogenesis.
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21
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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.
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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
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22
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Late Effects in Survivors After Hematopoietic Cell Transplantation in Childhood. PEDIATRIC ONCOLOGY 2014. [DOI: 10.1007/978-3-642-39920-6_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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23
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Nishimura S, Inada H, Sawa Y, Ishikawa H. Risk factors to cause tooth formation anomalies in chemotherapy of paediatric cancers. Eur J Cancer Care (Engl) 2013; 22:353-60. [PMID: 23336315 PMCID: PMC3655612 DOI: 10.1111/ecc.12038] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/28/2022]
Abstract
This study aimed to investigate the risk factors of tooth formation anomalies in anti-cancer chemotherapies. Long-term survivors treated by conventional chemotherapy (n = 26), conventional chemotherapy with high-dose chemotherapy (HDC) (n = 14), and HDC with total body irradiation (TBI) (n = 6) were analysed for the incidence of tooth agenesis, microdonts, and short-rooted teeth. The tooth agenesis and/or microdonts were found in second premolars and second molars, but not in first molars or central incisors. The ratio of subjects with tooth agenesis and/or microdonts was 66.7% and 18.2% in subjects administered conventional chemotherapy at <4 years and ≥4 years of age, respectively, while it was 100% and 25% in subjects administered HDC at <4 years and ≥4 years of age. The incidence of tooth formation anomalies did not related with the duration of conventional chemotherapy but increased by HDC. The incidence of tooth formation anomalies did not show significantly differences between the HDC with and without TBI groups, and was higher in busulfan-administered subjects than in subjects given cyclophosphamide. It may be concluded that the high-risk group of tooth agenesis is the subjects with HDC under 4 years of age. However, protocols of conventional chemotherapy are not an important risk factor to cause the tooth formation anomalies.
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Affiliation(s)
- S Nishimura
- Department of Oral Growth & Development, Fukuoka Dental College, Sawara-ku, Fukuoka, Japan
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24
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Vesterbacka M, Ringdén O, Remberger M, Huggare J, Dahllöf G. Disturbances in dental development and craniofacial growth in children treated with hematopoietic stem cell transplantation. Orthod Craniofac Res 2012; 15:21-9. [PMID: 22264324 DOI: 10.1111/j.1601-6343.2011.01533.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the correlation between age, degree of disturbances in dental development, and vertical growth of the face in children treated with hematopoietic stem cell transplantation (HSCT). PATIENTS 39 long-term survivors of HSCT performed in childhood and transplanted before the age of 12, at a mean age of 6.8±3.3 years. METHODS Panoramic and cephalometric radiographs were taken at a mean age of 16.2 years. For each patient two age- and sex-matched healthy controls were included. The area of three mandibular teeth was measured and a cephalometric analysis was performed. RESULTS The mean area of the mandibular central incisor, first and second molar was significantly smaller in the HSCT group, and the vertical growth of the face was significantly reduced, especially in the lower third, compared to healthy controls. A statistically significant correlation between age at HSCT, degree of disturbances in dental development, and vertical growth of the face was found. Children subjected to pre-HSCT chemotherapy protocols had significantly more growth reduction in vertical craniofacial variables compared to children without pre-HSCT chemotherapy. Conditioning regimens including busulfan or total body irradiation had similar deleterious effects on tooth area reduction and craniofacial parameters. CONCLUSIONS The younger the child is at HSCT, the greater the impairment in dental and vertical facial development. This supports the suggestion that the reduction in lower facial height found in SCT children mainly is a result of impaired dental development and that young age is a risk factor for more severe disturbances.
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Affiliation(s)
- M Vesterbacka
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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25
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Cubukcu CE, Sevinir B, Ercan I. Disturbed dental development of permanent teeth in children with solid tumors and lymphomas. Pediatr Blood Cancer 2012; 58:80-4. [PMID: 21254371 DOI: 10.1002/pbc.22902] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 10/11/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND Deficient dental root development has been reported after conventional pediatric anticancer therapy but less information is available on children with solid tumors and lymphomas. PROCEDURE We examined dental development from panoramic radiographs (PRGs) of 37 childhood cancer survivors (CCS) treated under the age of 10 years with multimodal chemotherapy (CT) and/or head and neck radiotherapy (RT). A novel defect index (DeI) was used to describe the total damage to permanent dentition. The DeI was also tested in matched controls. RESULTS All CCS had dental disturbances including abnormal root development (86.4%), microdontia (13.5%) and tooth agenesis (16.2%). Testing the controls gave the mean DeI value 1.9 ± 2.7 (range, 0-12), while the index scores in the study group varied from 0 to 49 (mean 10.8 ± 11.2) (P < 0.01). The statistical differences in the mean DeI values were insignificant between CT and CT and RT groups (P > 0.05). CONCLUSIONS Children treated for solid tumors and lymphomas are at considerable risk of some disturbances in developing dental structures. RT increased the severity of disturbances induced by CT. Studies should further elucidate dose-, age and time-related effects of anticancer treatment on dental development.
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26
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Hsieh SGS, Hibbert S, Shaw P, Ahern V, Arora M. Association of cyclophosphamide use with dental developmental defects and salivary gland dysfunction in recipients of childhood antineoplastic therapy. Cancer 2010; 117:2219-27. [PMID: 21523736 DOI: 10.1002/cncr.25704] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 09/09/2010] [Accepted: 09/10/2010] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to examine the effect of antineoplastic therapy on dental development and saliva function in recipients of childhood antineoplastic therapy. METHODS Patients attending the long-term follow-up clinic at Children's Hospital at Westmead, NSW, Australia, were included if they had received treatment prior to 16 years of age and were in remission for more than 5 years. A dental examination and saliva test were performed for each participant. Holtta's Defect Index (HDI) was used to assess tooth aplasia, microdontia, and root-crown ratio on an orthopantomogram (OPG). Multivariable-adjusted regression analyses were used to estimate the association of patient characteristics and treatment modalities with dental outcomes. RESULTS One hundred six participants (61% male) were recruited (response rate = 88%). The mean HDI score was 24.7 ± 17.8. A cumulative dose of cyclophosphamide >7500 mg/m(2) increased the HDI score by 13.06 (P = .01). Recipients of cyclophosphamide also had significantly increased odds of exhibiting very low saliva flow (<0.7 mL/min) (odds ratio = 12.43; 95% confidence interval, 2.08-74.35; P = .006). CONCLUSIONS Children and adolescents who received high doses of cyclophosphamide were at increased risk of dental disturbances. Cyclophosphamide recipients were also at greater risk of exhibiting very low saliva flow. This study applied the HDI to patients receiving all forms of antineoplastic treatment and highlights the dose-dependent relation between cumulative dose of cyclophosphamide and dental disturbances.
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Affiliation(s)
- Susan Gyea-Su Hsieh
- Westmead Centre for Oral Health, Children's Hospital at Westmead, Westmead, Australia.
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27
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Casillas J, Castellino SM, Hudson MM, Mertens AC, Lima ISF, Liu Q, Zeltzer LK, Yasui Y, Robison LL, Oeffinger KC. Impact of insurance type on survivor-focused and general preventive health care utilization in adult survivors of childhood cancer: the Childhood Cancer Survivor Study (CCSS). Cancer 2010; 117:1966-75. [PMID: 21509774 DOI: 10.1002/cncr.25688] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/26/2010] [Accepted: 09/02/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND Lack of health insurance is a key barrier to accessing care for chronic conditions and cancer screening. The influence of insurance type (private, public, none) on survivor-focused and general preventive health care in adult survivors of childhood cancer was examined. METHODS The Childhood Cancer Survivor Study is a retrospective cohort study of childhood cancer survivors diagnosed between 1970 and 1986. Among 8425 adult survivors, the relative risk (RR) and 95% confidence interval (CI) of receiving survivor-focused and general preventive health care were estimated for uninsured (n = 1390) and publicly insured (n = 640), compared with for the privately insured (n = 6395) RESULTS Uninsured survivors were less likely than those privately insured to report a cancer-related visit (adjusted RR, 0.83; 95% CI, 0.75-0.91) or a cancer center visit (adjusted RR, 0.83; 95% CI, 0.71-0.98). Uninsured survivors had lower levels of utilization in all measures of care in comparison with privately insured. In contrast, publicly insured survivors were more likely to report a cancer-related visit (adjusted RR, 1.22; 95% CI, 1.11-1.35) or a cancer center visit (adjusted RR, 1.41; 95% CI, 1.18-1.70) than were privately insured survivors. Although publicly insured survivors had similar utilization of general health examinations, they were less likely to report a Papanicolaou test or a dental examinations CONCLUSIONS Among this large, socioeconomically diverse cohort, publicly insured survivors utilize survivor-focused health care at rates at least as high as survivors with private insurance. Uninsured survivors have lower utilization of both survivor-focused and general preventive health care.
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Affiliation(s)
- Jacqueline Casillas
- Department of Pediatrics, University of California Los Angeles, Los Angeles, California 90095, USA.
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28
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Meier JKH, Wolff D, Pavletic S, Greinix H, Gosau M, Bertz H, Lee SJ, Lawitschka A, Elad S. Oral chronic graft-versus-host disease: report from the International Consensus Conference on clinical practice in cGVHD. Clin Oral Investig 2010; 15:127-39. [PMID: 20859645 DOI: 10.1007/s00784-010-0450-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2010] [Accepted: 07/26/2010] [Indexed: 01/12/2023]
Abstract
Chronic graft-versus-host disease (cGVHD) is a multi-organ disease that occurs post-hematopoietic stem cell transplantation, with the mouth being one of the most frequently affected organs. In 2009, the German-Austrian-Swiss working party on bone marrow and blood stem cell transplantation held a consensus conference to define clinical management of cGVHD. The consensus conference aimed to summarize the literature on diagnosis and topical treatment options for oral cGVHD and to provide recommendations for clinical practice, including routine dental and oral care as well as monitoring for secondary malignancies and bisphophonate-induced osteonecrosis of the jaw.
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Affiliation(s)
- Johannes K-H Meier
- Department of Cranio-Maxillo-Facial Surgery, University of Regensburg, Regensburg, Germany
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29
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Allen G, Logan R, Gue S. Oral Manifestations of Cancer Treatment in Children. Clin J Oncol Nurs 2010; 14:481-90. [DOI: 10.1188/10.cjon.481-490] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Late effects and quality of life of childhood cancer survivors: part 1. Impact of stem cell transplantation. Int J Hematol 2010; 91:865-76. [PMID: 20467848 DOI: 10.1007/s12185-010-0584-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 04/20/2010] [Accepted: 04/21/2010] [Indexed: 10/19/2022]
Abstract
To examine the late effects and health-related quality of life among childhood cancer survivors (CCS) after stem cell transplantation (SCT), we performed a cross-sectional survey using self-rating questionnaires. The subjects were divided into 3 groups: SCT-treated CCS, CCS treated without SCT, and the general population who matched for age, gender, residential area, and work status with the CCS. We analyzed the questionnaires of 185 CCS and 1,000 control participants. The median ages of CCS at diagnosis and survey were 8 and 22 years, respectively. The mean final heights of male and female participants were significantly lower for SCT-treated CCS than for CCS treated without SCT and the controls. Among the SCT-treated CCS, >40% were underweight (BMI < 18.5). Late effects were observed in 78% of SCT-treated CCS versus 45% of CCS treated without SCT. Multivariate analysis revealed that >15 years' duration after therapy completion (OR 2.95; p = 0.014), solid tumors (4.31; p = 0.040), radiotherapy (2.82; p = 0.009), recurrence (4.22; p = 0.017), and SCT (3.39; p = 0.014) were significant risk factors for late effects. Subjective symptoms were significantly frequent in SCT-treated CCS. Physical dysfunction, psychological stress, and social adaptation problems were observed in >70% of SCT-treated CCS.
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31
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High burden of late effects after haematopoietic stem cell transplantation in childhood: a single-centre study. Bone Marrow Transplant 2009; 45:79-85. [DOI: 10.1038/bmt.2009.92] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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