The relation of the therapy used and age at diagnosis to developmental defects of dental enamel and root was analyzed in 45 survivors of childhood acute lymphoblastic leukemia (ALL) and compared to that of age- and sex-matched healthy controls. Chemotherapy alone increased the number of enamel defects, but it did not affect the roots. The scattered irradiation of 0.72-1.44 Gy to the dental arches during central nervous system (CNS) irradiation caused an increased number of developmental defects both in enamel and root. Age at diagnosis is an important factor and it showed that the irradiation of 10 Gy did not cause enamel defects if amelogenesis was complete. In conclusion, the therapy is related to developmental defects of the teeth but the most important factor is age, both at diagnosis and during the therapy.
Data on two patients with cyclic neutropenia are presented. They demonstrate that regular tooth care and professional dental treatment can prevent progressive periodontal breakdown but that neglecting oral hygiene soon leads to periodontal pathology. Regular, monthly professional removal of dental plaque and calculus, and rinsing with 0.2% chlorhexidine gluconate during neutropenia help maintain periodontal attachment level. The caries susceptibility and the apical periodontitis in the intact anterior tooth of the female patient indicate the possibility of cyclic neutropenia playing a role in caries and pulpal pathology.
– Salivary immunoglobulins, lysozyme, pH, and microbial counts were determined in 55 children with cancer diseases (37 cured subjects and 18 acute ones) and 103 healthy subjects. 5–10 ml unstimulated whole saliva was collected and pH, immunoglobulins and lysozyme were measured. Chairside dip‐slide cultivations were used for microbiologic cultures. Reduced salivary pH and an increased amount of lysozyme were found in the saliva of those children who had been cured of their cancer diseases, but ongoing cancer disease or the treatment provided for it reduced pH and increased the amounts of lysozyme, lactobacillus, Streptococcus mutans and some immunoglobulins. These findings suggest that children with childhood cancer may be more susceptible to dental diseases than healthy ones.
The prevalence and location of enamel opacities was recorded in 37 subjects from low-fluoride areas who had received anti-neoplastic therapy and was compared with an equal number of healthy controls. All the patients had received combination chemotherapy for a malignant disease for at least 2 yr early on in their lives. These cases, and especially those with leukemia, had more opacities than the controls, although these opacities were mild in form. The results show that childhood cancer and/or the therapy provided for this can affect the developing dentition, involving all teeth in leukemia cases and the permanent teeth of the mixed dentition period in other cancer diseases.
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