Late effects of chemo and radiation treatment on dental structures of childhood cancer survivors. A systematic review and meta‐analysis

Abstract

Background This systematic review summarizes the prevalence of dental defects after chemo and radiation therapy and correlates the findings with specific characteristics of each treatment modality. Methods Database search was performed for studies reporting dental late effects of chemo and radiation therapy. After data extraction and risk of bias assessment, prevalence of crown and root defects was assessed. Correlations between each defect and the characteristics of the antineoplastic treatment were performed. Results Sixteen nonrandomized studies were included, yielding a total of 1300 patients with a mean age at diagnosis of 4.5 years. Results reported that root defects were more common than crown defects. The most common root defect was impaired root growth and microdontia the most common crown defect. Age, radiation dose and field were statistically associated with higher prevalence of dental defects. Conclusion Defects were associated with combination of chemotherapy and radiotherapy, as used in current therapeutic antineoplastic modalities.

Reabilitação oral conservadora em paciente juvenil com alterações orofaciais secundárias ao tratamento de rabdomiossarcoma em cabeça e pescoço: relato de caso / Conservative oral rehabilitation in a juvenile patient with orofacial alterations secondary to the treatment of rhabdomyosarcoma in the head and neck: case report

“…Cabe destacar que tanto a quimioterapia quanto a radioterapia, com algumas diferenças no mecanismo de ação, atuam sobre o processo de divisão celular (5,(7)(8) . Como os tecidos normais da criança, inclusive o dentário, encontram-se em processo proliferativo para promover o crescimento e o desenvolvimento do organismo, também são afetados por essas modalidades terapêuticas (4)(5)(7)(8) . Desta forma, tratamentos para tumores de cabeça e pescoço em pediatria induzem distúrbios de desenvolvimento crânio facial cuja intensidade será determinada pela idade do paciente no início do tratamento, a modalidade terapêutica e a dose administrada (4)(5)(6)(7)13) .…”

“…Estima-se que 75% dos pacientes sobreviventes apresentam alguma sequela resultante do tratamento, inclusive na boca (3) . A quimioterapia sistêmica e/ou a radioterapia em região de cabeça e pescoço são capazes de desencadear alterações no desenvolvimento de dentes e estruturas da face (4)(5)(6)(7) .…”

“…Entre os distúrbios mais comumente encontrados em crianças estão anomalias ósseas, agenesias dentárias, microdontias, anomalias de esmalte e, sobretudo, malformações radiculares e coronárias (3)(4)(5)(6)(7)(8) . A frequência e intensidade dessas alterações estão relacionadas com a idade da criança durante o tratamento, a modalidade terapêutica utilizada, regime quimioterápico, tipo e dose de radiação e a área da face irradiada (4)(5) .…”

Long-Term Effects of Childhood Cancer Treatment on Dentition and Oral Health: A Dentist Survey Study from the DCCSS LATER 2 Study

“…Amongst these late effects, oral health problems related to cancer treatments have been reported [ 4 ]. Oral late effects may include dental developmental disorders, craniofacial abnormalities, gingivitis, dental caries, salivary gland dysfunction, and xerostomia [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

Association between tooth agenesis and cancer: a systematic review

“…1,4 Some environmental factors could interfere with odontogenesis, which includes trauma, infection, smoking, surgery, and others. [5][6][7][8] Tooth agenesis is also related with genetic syndromes including ectodermal dysplasia and Klinefelter syndrome. 9 Therefore, this condition may also be classified as syndromic or nonsyndromic.…”