Long-Term Effects of Acute Myeloid Leukemia Treatment on the Oral System in a Pediatric Patient

Abstract

Introduction:Acute Myeloid Leukemia (AML) in pediatric patients is a serious disease, although, for the subgroup of patients who receive proper treatment, a long-term survival rate above 50% is typical. The cycles of chemo- and radiotherapy used to treat AML can impair dental development.Case Report:Herein, we describe the oral condition of a 25-year-old male patient treated for AML with chemo- and radiotherapy from 5 to 7 years of age; his AML has remained in remission for the past 18 years. He had lost only one permanent tooth, but the remaining teeth demonstrated serious deformations and radicular hypoplasia. Two teeth required immediate extraction and subsequent replacement by implant-supported crowns. We found that the decayed, missing, filled teeth (DMFT) index was not representative of the real oral condition. Here, we report the full case and provide a brief review of the literature.Conclusion:Antitumor treatment of pediatric leukemia can induce total impairment of dental development and function. These adverse effects may become clinically evident many years after the resolution of cancer, and can be significantly detrimental to the patient’s quality of life.

Oral Manifestations and Complications in Childhood Acute Myeloid Leukemia

“…Leukemia is a heterogeneous group of hematological disorders arising from hematopoietic stem cells [1], resulting from the uncontrolled proliferation of neoplastic cells [2,3], characterized by impaired differentiation [1,2] and programmed cell death [2]. The failure of maturation of precursor cells results in the accumulation of blasts in the bone marrow with consequent suppression of normal hematopoiesis, leading to deficiency of mature leukocytes, erythrocytes, and platelets [4].…”

“…The failure of maturation of precursor cells results in the accumulation of blasts in the bone marrow with consequent suppression of normal hematopoiesis, leading to deficiency of mature leukocytes, erythrocytes, and platelets [4]. Life-threatening complications are represented by infections, frequently recurrent, as well as severe bleeding episodes [1][2][3]5]. Leukemic cells can invade various organs: Liver, spleen, central nervous system (CNS), bone, and the gingiva.…”

“…Leukemic cells can invade various organs: Liver, spleen, central nervous system (CNS), bone, and the gingiva. Gingival infiltration can be demonstrated by biopsy [1,3].…”

“…Leukemia is the most common form of pediatric cancer in children younger than 15 years old [3,6]. Worldwide incidence is 3.7 per 100,000 and accounts for about 4% of all deaths from malignancies [4].…”

Micro-Raman Spectroscopy of Dental Implants Subjected to Different Surface Treatments

“…From Brånemark's initial studies, titanium represents the most-used material, although not the only one, for the production of endosseous dental implants [1][2][3]. Success rates with titanium implants are high in both the short and long term; moreover, they are indicated in many particular situations [4][5][6][7][8][9][10].…”