Long-term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors

Avşar, Aysun; Elli, Murat; Darka, Özge; Pınarlı, Faruk Güçlü

doi:10.1016/j.tripleo.2007.02.029

Cited by 100 publications

(150 citation statements)

References 31 publications

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“…As a result, no adequate measures are taken referred to the complications that may appear in any structure of the stomatognathic apparatus (14,16,26). This situation is particularly worrisome in pediatric oncological patients in which the late effects of cancer treatment upon dental and ma�illary development are frequently not taken into account (27).…”

Section: Discussionmentioning

confidence: 99%

Dental implications in oral cancer patients

et al. 2011

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Objectives. A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. Patients and Methods. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Ma�illofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Results. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus e�cluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, �erostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Conclusions. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives.

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Section: Discussionmentioning

confidence: 99%

Dental implications in oral cancer patients

et al. 2011

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“…36 Clinical demonstrations of the dental effects of cyclophosphamide (or chemotherapy alone) are scarce. 24 In a recent case report of 3 children with severe combined immunodeficiency conditioned with high-dose cyclophosphamide and busulfan, short roots and microdontia were reported. 44 The total duration of treatment was 10 days, and no other chemotherapeutic agents were given.…”

Section: Discussionmentioning

confidence: 99%

“…Reports on the correlation between caries prevalence and chemotherapy exposure in other studies have been inconsistent. 24,55 It is possible that participants attending our long-term follow-up clinic, particularly those who received cyclophosphamide and/or HPCT, were generally a more carefully monitored group of patients due to their increased risk of developing other conditions. Therefore, this group of patients were more likely to receive appropriate dental education and early intervention, thus minimizing the risk of dental caries.…”

Section: Discussionmentioning

confidence: 99%

“…22 However, few clinical studies have been conducted to examine the impact of specific chemotherapeutic agents on oral health outcomes in children. 23,24 In our cohort of patients, we assessed the effect of antineoplastic therapy on dental development and salivary gland function in a cohort of recipients of childhood antineoplastic therapy. The current study focuses on the association of chemotherapeutic agents, particularly cyclophosphamide, with dental development and saliva function.…”

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confidence: 99%

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Association of cyclophosphamide use with dental developmental defects and salivary gland dysfunction in recipients of childhood antineoplastic therapy

Hsieh

Hibbert

Shaw

et al. 2010

Cancer

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BACKGROUND:The aim of this study was to examine the effect of antineoplastic therapy on dental development and saliva function in recipients of childhood antineoplastic therapy. METHODS: Patients attending the long-term follow-up clinic at Children's Hospital at Westmead, NSW, Australia, were included if they had received treatment prior to 16 years of age and were in remission for more than 5 years. A dental examination and saliva test were performed for each participant. Holtta's Defect Index (HDI) was used to assess tooth aplasia, microdontia, and root-crown ratio on an orthopantomogram (OPG). Multivariable-adjusted regression analyses were used to estimate the association of patient characteristics and treatment modalities with dental outcomes. RESULTS: One hundred six participants (61% male) were recruited (response rate ¼ 88%). The mean HDI score was 24.7 AE 17.8. A cumulative dose of cyclophosphamide >7500 mg/m 2 increased the HDI score by 13.06 (P ¼ .01). Recipients of cyclophosphamide also had significantly increased odds of exhibiting very low saliva flow (<0.7 mL/min) (odds ratio ¼ 12.43; 95% confidence interval, 2.08-74.35; P ¼ .006). CONCLUSIONS: Children and adolescents who received high doses of cyclophosphamide were at increased risk of dental disturbances. Cyclophosphamide recipients were also at greater risk of exhibiting very low saliva flow. This study applied the HDI to patients receiving all forms of antineoplastic treatment and highlights the dose-dependent relation between cumulative dose of cyclophosphamide and dental disturbances.

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“…13 Avsar et al reported in their case-control study that 96 survivors of childhood cancer treated with chemotherapy and no radiation had lower salivary flow rate and higher cariogenic bacteria such as Streptococcus mutans and Lactobacillus. 14 The higher DMFT values recorded in ALL children were explained by the presence of demineralization defects that favored the cariogenic activity of oral microorganisms. The DMFT score is considered to be a useful predictor of caries in permanent teeth.…”

Section: Discussionmentioning

confidence: 99%

Original Research. The Evaluation of Caries Severity Index and Dental Hypoplasia in Children with Acute Lymphoblastic Leukemia. Results from a Romanian Medical Center

Bică

Ion

Martha

et al. 2017

Journal of Interdisciplinary Medicine

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Acute lymphoblastic leukemia (ALL) is a type of cancer that most frequently affects children, and its treatment involves intensive chemotherapy, which might interfere with the normal development of dental tissues. The aim of our study was to measure the incidence of dental caries and enamel hypoplasia in children diagnosed with ALL treated according to the Berlin-Frankfurt-Munster-95 (ALL-BFM-95) protocol during the complete remission phase. Two groups of children between 8-12 years of age were investigated: Group 1 consisted of 36 children with ALL, and Group 2 of 58 control age-matched children. The decay-missing-filling index for the deciduous teeth (DMFT) and the presence of hypoplasia in the first permanent molars (MH) or in both incisors and molars (MIH) were recorded. The results were statistically analyzed and showed that there were no differences between the groups regarding the DMFT values (p >0.05), but there was a statistically significant difference in the incidence of MH and MIH between groups (p <0.05). According to our results, chemotherapy was not responsible for the decay process, as there were no differences in DMFT indices between the groups, but the high incidence of MH and MIH in the ALL group indicates the need of a good dental care for these children in order to prevent future dental complications.

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Long-term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors

Cited by 100 publications

References 31 publications

Dental implications in oral cancer patients

Dental implications in oral cancer patients

Association of cyclophosphamide use with dental developmental defects and salivary gland dysfunction in recipients of childhood antineoplastic therapy

Original Research. The Evaluation of Caries Severity Index and Dental Hypoplasia in Children with Acute Lymphoblastic Leukemia. Results from a Romanian Medical Center

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