A Long-Term Follow-Up of Dental and Craniofacial Disturbances after Cancer Therapy in a Pediatric Rhabdomyosarcoma Patient: Case Report

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.

The Impact of Benign Jawbone Tumors on the Temporomandibular Joint and Occlusion in Children: A Ten-Year Follow-Up Study

This study aimed to provide a complex analysis of the modifications in craniofacial skeleton development that may arise following the diagnosis of pediatric benign jaw tumors. A prospective study was undertaken involving 53 patients younger than 18 years of age, who presented for treatment at the Department of Maxillo-Facial Surgery, University of Medicine and Pharmacy, Cluj-Napoca, with a primary benign jaw lesion between 2012 and 2022. A total of 28 odontogenic cysts (OCs), 14 odontogenic tumors (OTs), and 11 non-OTs were identified. At follow-up, dental anomalies were identified in 26 patients, and overjet changes were found in 33 children; lateral crossbite, midline shift, and edge-to-edge bite were found in 49 cases; deep or open bite were found in 23 patients. Temporomandibular disorders (TMDs) were found in 51 children, with unilateral TMJ changes identified in 7 cases and bilateral modifications found in 44 patients. Degenerative changes in the TMJ were also diagnosed in 22 pediatric patients. Although benign lesions could be associated with dental malocclusions, a direct etiological factor could be not identified. The presence of jaw tumors or their surgical treatment could, however, be linked to a change of the occlusal relationships or the onset of a TMD.