Impact of Hematopoietic Stem Cell Transplantation on Dental Development

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.

A nationwide survey of late effects in survivors of juvenile myelomonocytic leukemia in Japan

“…HSCT in younger children, especially those below 3 years old, is highly related to dental problems, including agenesis, microdontia, enamel hypoplasia, and extensive caries. Although the prevalence was relatively low in this study, we confirmed the results reported previously 12,13 …”

Impact of Pediatric Hematopoietic Stem-Cell Transplantation on Craniofacial Growth

“…The early detection of craniofacial deformities is important to provide childhood HSCT survivors proper care and mitigate the quality of life impairment associated with oncologic treatments. Panoramic radiographs present as a trustworthy and cost-effective tool for craniofacial growth screening early malocclusion diagnosis ( 23 , 24 ).…”

Oral changes in patients before and after transplantation of solid organs and hematopoietic stem cells

“…Owing to their myelosuppressive action, cytostatics lead to thrombocytopenia and granulocytopenia. Thrombocytopenia results in onset of petechiae in oral mucosa and frequent bleeding in the oral cavity, and granulocytopenia leads to an increased risk of the occurrence of oral infections [36]. Due to changes in oral mucous membrane and parenchyma of the salivary glands after the application of therapy for hematologic malignancies, as well as stress, in the period prior to the tissue and cell transplantation, reduction in the secretion of stimulated saliva may be observed.…”

“…In children subjected to high doses of chemotherapy and radiation therapy during treatment of malignant diseases more frequent occurrence of developmental dental anomalies is observed several years after the hematopoietic stem cell transplantation. Structural irregularities in the teeth, mineralization disorders of hard dental tissues, irregularities in the length and shape of the teeth roots, reduced tooth crown size, as well as the lack of a smaller or greater number of teeth may occur [36,41].…”