Dental age estimation in children that have undergone antineoplastic treatment

Dental management of long-term childhood cancer survivors: a systematic review

PURPOSE

Critically review and summarise existing knowledge on prevalence of oral, dental, and craniofacial side-effects of antineoplastic treatment in childhood cancer survivors (CCS).

METHODS

A literature search was conducted for studies reporting on children aged 4-19 years treated for any type of malignancy up to the age of 15 years and for whom, at the time of the examination, more than 8 months have elapsed since the end of treatment. Data regarding dental late effects on teeth and craniofacial complex were collected and mean prevalence of each defect was reported.

RESULTS

From the 800 articles identified, 17 studies fulfilled inclusion criteria and were included. A total of 983 CCS were examined, with the total number of healthy controls being 1266 children. Haematological malignancy was the most prevalent diagnosis with the age at diagnosis ranging between 0-15 years. Multiple antineoplastic protocols were implemented with the elapsed time being 8 months up to 17 years. One-third of CCS experienced at least one late effect, with corresponding value for the control group being below 25%. Among the defects identified clinically, microdontia, hypodontia and enamel developmental defects were recorded in 1/4 of CCS. Impaired root growth and agenesis were the two defects mostly recorded radiographically. The effect on dental maturity and on salivary glands was unclear.

CONCLUSION

CCS are at risk of developing dental late effects because of their disease and its treatment and therefore, routine periodic examinations are essential to record their development and provide comprehensive oral healthcare.

Age estimation using London Atlas methodology: A systematic review and meta-analysis

Age estimation is a fundamental competence of Forensic Anthropologists and Odontologists. The London Atlas is a dental development chart by AlQahtani et al. (2010) that gained recent notoriety due to its applicability in forensic scenarios. This study aimed to answer, by a systematic review of literature and meta-analysis, the following question: "on average, what is the deviation between real and estimated ages, when applying the London Atlas method in sub-adults?". This study was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO). Five electronic databases were screened (PubMed, SciELO, Scopus, Web of Science, and LILACS), and active search was carried out. The quality assessment was performed by means of Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. The initial search resulted in 1021 studies, from which 24 filled the inclusion criteria. For the meta-analysis, 17 studies provided sufficient data. Out of these, eleven studies enabled meta-analysis of mean absolute difference values. Standardized mean differences were 0.02 years for MD and 0.78 for MAD. Analysis of subgroups was also accomplished by sex, and did not indicated heterogeneity between males and females. The London Atlas is an accurate age estimation method, presenting acceptable error and bias values worldwide. Despite the high heterogeneity of the studies, majority of studies presented a low risk of bias. Meta-analysis showed a non-significant and slight tendency of overestimating age, in total. Sub-group analysis showed modestly better results for boys than girls.