Agenesis and microdontia of permanent teeth as late adverse effects after stem cell transplantation in young children

Abstract

BACKGROUNDThe objective of the current study was to examine the occurrence of tooth agenesis and microdontia in pediatric stem cell transplantation (SCT) recipients.METHODSThe impact of total body irradiation (TBI) and age at SCT on agenesis and microdontia of permanent teeth was examined in 55 patients from panoramic radiographs. Assessment A1 (for tooth agenesis and microdontia) excluded the third molars, and assessment A2 (for tooth agenesis) included the third molars. Patients were grouped according to TBI status (the TBI group vs. the non‐TBI group) and age at SCT (patients age ≤ 3.0 years [Group Y], patients ages 3.1–5.0 years [Group M], and patients age ≥ 5.1 years [Group O]).RESULTSFrom 1 to 12 teeth were missing in 77%, 40%, and 0% of patients (assessment A1) in Groups Y, M, and O, respectively (Group Y vs. Group M, P = 0.055; Group Y vs. Group O, P < 0.001; and Group M vs. Group O, P = 0.002), increasing to 83%, 78%, and 43%, respectively, when the third molars were included (assessment A2; P values were not significant). Correspondingly, 75%, 60%, and 13%, respectively, of patients had 1–12 microdontic teeth (assessment A1: Group Y vs. Group M, P = 0.306; Group Y vs. Group O, P < 0.001; and Group M vs. Group O, P = 0.003). Recipient age at the time of SCT was found to have a negative correlation with the number of missing teeth (P = 0.001) and microdontic teeth (P = 0.005). TBI appeared to have little effect on the prevalence of tooth agenesis (assessment A1: TBI group, 32%; non‐TBI group, 29%; assessment A2: TBI group, 72%; non‐TBI group, 46%; P values were not significant) or on the prevalence of microdontia (assessment A1: TBI, 41%; non‐TBI, 50%; P value was not significant). A tendency toward an increased number of affected teeth was noticed in the group of patients who received TBI.CONCLUSIONSDepending on their age at SCT, 50–100% of pediatric SCT recipients will later present with agenesis and/or microdontia of permanent teeth that may jeopardize occlusal development. Young age (≤ 5.0 years) at SCT was found to be a stronger risk factor than TBI, although TBI caused additive impairment. Cancer, 2005. © 2004 American Cancer Society.

Burkitt s lymphoma: a child s case presenting in the maxilla. Clinical and radiological aspects.

“…Specific periodontal problems may also appear showing a decrease of the osteoblastic and osteoclastic activity in the alveolar bone, almost complete lack of osteocytes, and degeneration of fat marrow. Odontoblastic activity stops in developing teeth, with the result of agenesias and microdontias (15,17).…”

Agenesis of a large number of permanent teeth after treatment of neonatal leukemia

“…HDC tends to cause more frequent and more severe dental abnormalities compared with conventional chemotherapy. The number of missing teeth in SCT patients reportedly ranged from 1 to 12 teeth [4]. In our case, a total of 21 permanent teeth, excluding four third molars, were missing.…”

“…There have been few studies on SCT recipients. It was reported that the preparative regimens for SCT caused tooth agenesis at frequencies ranging from 31 to 80% [1,4,8]. HDC tends to cause more frequent and more severe dental abnormalities compared with conventional chemotherapy.…”

“…Multiagent chemotherapy and radiotherapy are known to cause tooth agenesis when used in pediatric cancer patients. The percentage of cancer patients with missing teeth is reported to range from 5 to 28% after conventional chemotherapy [1,4]. There have been few studies on SCT recipients.…”

“…Dental abnormalities including root stunting, microdontia, hypodontia, taurodontia, over-retention of primary dentition, etc. [3,4] have been reported. However, few studies have reported deficiency of a large number of permanent teeth.…”