The Broad Variability in Dental Age Observed among Childhood Survivors Is Cancer Specific

Abstract

Purpose The study aimed to assess the differences in dental maturation between childhood cancer survivors and healthy children. Materials and Methods Fifty-nine cancer patients including 16 (27.1%) girls and 43 (72.8%) boys, aged between 4 and 16 years, underwent dental and radiographic examinations. The mean duration of anticancer therapy was 16.8 months (range, 1 to 47 months), and 4.6 years (range, 8 to 123 months) had passed since the termination of disease. The control group consisted of 177 panoramic radiographs of age- and sex-matched healthy individuals. Dental age (DA) was estimated with Demirjian’s scale and delta age, i.e., DA–chronological age (CA), was used to compare groups. Results The DA of cancer survivors was accelerated by almost 1 year compared to their CA (9.9±3.1 vs. 8.9±2.8, p=0.040). The greatest difference was observed among patients with brain tumor: delta (DA–CA) was 2.2±1.1 years. Among all cancer patients, only children with familial adenomatous polyposis (FAP)-associated hepatoblastoma (HP) demonstrated delayed DA, with regard to both other cancer survivors (p=0.011) and healthy patients (p=0.037). All four patients with HP suffered from FAP, and three of them had documented adenomatous polyposis coli ( APC ) genes mutation. The DA of cancer patients having teeth with short roots was significantly greater than that of the cancer survivors without this anomaly (12.8±3.2 vs. 9.0±2.4, p < 0.001). Conclusion DA in children may be altered by cancer disease.

Comparative Study of Malocclusions between Cancer Patients and Healthy Peers

“…Previously, it was also found that cancer not only affects tooth development but also disturbs the process of dental maturity [ 14 ]. In most cases, cancer therapy may accelerate dental age; however, it was found to be delayed in patients suffering from (FAP)-associated hepatoblastoma [ 14 ].…”

“…Previously, it was also found that cancer not only affects tooth development but also disturbs the process of dental maturity [ 14 ]. In most cases, cancer therapy may accelerate dental age; however, it was found to be delayed in patients suffering from (FAP)-associated hepatoblastoma [ 14 ]. Celikoglu et al found that orthodontic patients with skeletal malocclusions demonstrated approximately twice the mean difference between dental and chronological time than patients with Class I [ 28 ].…”

“…Childhood cancer survivors often suffer from various dental anomalies, such as misshaped tooth roots, missing or microdontic teeth, as well as various other dental complications—including dental caries or hypoplasia [ 12 , 13 ]. Cancer survivors sometimes present a significantly different dental age to healthy children at a similar chronological age [ 14 ]. It is well known fact that the dental complications may influence occlusion in healthy children [ 15 , 16 , 17 ].…”

Late dental effects of chemotherapy and radiotherapy in childhood cancer survivor: case report

“…Essas drogas não se restringem apenas às células tumorais, mas sim a todas as células em multiplicação, provocando efeitos colaterais agudos como mucosite oral, alopecia, neutropenia e infecções oportunistas (Figliolia et al, 2008;Muniz et al, 2021). Pacientes pediátricos além dos efeitos agudos, também estão sujeitos a desenvolverem alterações tardias em estruturas que estiverem em formação (Günen Yılmaz et al, 2018;Proc et al, 2021). Uma recente revisão de literatura incluiu artigos publicados que relataram os principais efeitos agudos e tardios do tratamento oncológico.…”