Research Article
Volume 20 Issue 12 - 2021
Dental Anomalies after Chemotherapy in Childhood Cancer Survivors: A Cross Sectional Study

Ghada Adel Tahoun1*, Sara Ahmed Mahmoud3, Lobna Mohamed Shalaby2 and Amr Ezzat Abd EL Latif3

1Department of Dentistry, Children’s Cancer Hospital Egypt
2Department of Pediatric Oncology, Children’s Cancer Hospital Egypt 57357
3Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Egypt
*Corresponding Author: Ghada Adel Tahoun, Department of Dentistry, Children's Cancer Hospital Egypt.
Received: November 05, 2021; Published: November 29, 2021




Abstract

Background: Since cancer therapy regimens mostly involve combinations of chemotherapy, radiotherapy, bone marrow transplantation and/or surgery, determining the causality of the dental anomalies observed in cohorts of childhood cancer survivors has been a challenge. Fortunately, effects of radiotherapy and surgery are localized however, due to the lack of specificity of these agents, chemotherapy affects the entire body. Therefore, this study aims to describe the effect of chemotherapy on dental development.
Methods: A total of 144 cancer survivors were selected from Children Cancer Hospital Egypt 57357 using stratified random sampling. The selected subjects matched the following criteria: (1) cancer survivors who were at least 6 years old (2) children who first started receiving chemotherapy at 4 years old or younger. We excluded (1) children who received radiotherapy on head and/or neck (2) children who received bone marrow transplantation (3) children with any associated developmental anomalies. Eligible subjects were assessed radiographically for dental anomalies of the permanent dentition using Holtta's Defect Index (DeI).
Results: 70.14% of the subjects had at least one dental anomaly (DeI ≥ 1). The highest mean DeI was of bone tumors while the least mean was of soft tissue sarcoma. The most frequently detected anomaly was microdontia (56.9%). Microdontia occurred most commonly (71%) in Acute Myeloid Leukemia and Non-Hodgkin's Lymphoma, while root resorption and hypdontia affected mostly bone tumors (66.67%, 33.33%, respectively).

Conclusion: This study confirms that children who receive antineoplastic chemotherapy before the age of 4 years are at high risk of developing dental anomalies.

Keywords: Tooth Abnormalities; Neoplasms; Drug therapy; Anadontia; Tooth Root; Tooth Crown; Cancer Survivors

References

  1. American Cancer Society. American Cancer Society: Cancer Facts and Figures 2018. Atlanta: American Cancer Society (2019).
  2. Vonderweid N., et al. “Standardized assessment of late effects in long-term survivors of childhood cancer in Switzerland: results of a Swiss Pediatric Oncology Group (SPOG) pilot study”. International Journal of Pediatric Hematology/Oncology 3 (1996): 483.
  3. Stevens M., et al. “The health status of adult survivors of cancer in childhood”. European Journal of Cancer5 (1998): 694-698.
  4. Oeffinger K., et al. “Grading of late effects in young adult survivors of childhood cancer followed in an ambulatory adult setting”. Cancer7 (2000): 1687-1695.
  5. Holtta P., et al. “Long-Term Adverse Effects on Dentition in Children with Poor-Risk Neuroblastoma Treated with High-Dose Chemotherapy and Autologous Stem Cell Transplantation with or without Total Body Irradiation”. Bone Marrow Transplant2 (2002): 121-127.
  6. Lopes N., et al. “Dental Abnormalities in Children Submitted to Antineoplastic Therapy”. Journal of Dentistry for Children3 (2006):140-145.
  7. Sevinir M., et al. “Disturbed Dental Development of Permanent Teeth in Children with Solid Tumors and Lymphomas”. Pediatric Blood and Cancer1 (2012): 80-84.
  8. Pedersen L., et al. “Microdontia and Hypodontia of Premolars and Permanent Molars in Childhood Cancer Survivors after Chemotherapy”. International Journal of Paediatric Dentistry 22 (2012): 239-243.
  9. Krasuska-Sławińska E., et al. “Antineoplastic Chemotherapy and Congenital Tooth Abnormalities in Children and Adolescents”. Contemporary Oncology5 (2016): 394-401.
  10. Nishimura S., et al. “Risk Factors to Cause Tooth Formation Anomalies in Chemotherapy of Paediatric Cancers”. European Journal of Cancer Care3 (2013): 353-360.
  11. Khojastepour L., et al. “Dental Anomalies and Dental Age Assessment in Treated Children with Acute Lymphoblastic Leukemia”. Iranian Journal of Pediatric Hematology and Oncology4 (2014): 172-177.
  12. Sonis A., et al. “Dentofacial Development in Long-Term Survivors of Acute Lymphoblastic Leukemia. A Comparison of Three Treatment Modalities”. Cancer12 (1990): 2645-2652.
  13. Nunn J., et al. “Dental Caries and Dental Anomalies in Children Treated by Chemotherapy for Malignant Disease: A Study in the North of England”. International Journal of Paediatric Dentistry3 (1991): 131-135.
  14. Kaste S., et al. “Dental Abnormalities in Children Treated for Acute Lymphoblastic Leukemia”. Leukemia6 (1997): 792-796.
  15. Maciel J., et al. “Oral Health and Dental Anomalies in Patients Treated for Leukemia in Childhood and Adolescence”. Pediatric Blood and Cancer3 (2009): 361-65.
  16. Minicucci E., et al. “Dental Abnormalities in Children after Chemotherapy Treatment for Acute Lymphoid Leukemia”. Leukemia Research1 (2003): 45-50.
  17. El Noury H., et al. “Radiographic and Clinical Assessment of the Effect of Chemotherapy on the Development of Permanent Dentition in Children with Acute Lymphoid Leukemia (a Cross-Sectional Study). Cairo University,Cairo,Egypt (2016).
  18. Denyer M. “Medical Statistics at a Glance”. Journal of Anatomy 4 (2010): 543-543.
  19. Gawade P., et al. "A Systematic Review of Dental Late Effects in Survivors of Childhood Cancer”. Pediatric Blood and Cancer 3 (2014): 407-416.
  20. Vahid-Dastjerdi E., et al. “Non-Syndromic Hypodontia in an Iranian Orthodontic Population”. The Journal of Oral Science 3 (2010): 455-461.
  21. Kim Y. “Investigation of Hypodontia as Clinically Related Dental Anomaly: Prevalence and Characteristics”. ISRN Dentistry 1 (2011): 1-6.
  22. Rakhshan V. “Congenitally Missing Teeth (Hypodontia): A Review of the Literature Concerning the Etiology, Prevalence, Risk Factors, Patterns and Treatment”. Journal of Dental Research 1 (2015): 1-13.
  23. Abe R., et al. “Maxillary First Molar Agenesis and Other Dental Anomalies”. The Angle Orthodontist 6 (2010): 1002-1009.
  24. Montasser M and Taha M. “Prevalence and Distribution of Dental Anomalies in Orthodontic Patients”. Orthodontics 1 (2012): 52-59.
  25. Lotfy R., et al. “Prevalence of Certain Dental Anomalies in a Group of Young Egyptians.Cairo University,Cairo,Egypt (2014).
  26. Oguz A., et al. “Long-Term Effects of Chemotherapy on Orodental Structures in Children with Non-Hodgkin's Lymphoma”. European Journal of Oral Sciences 1 (2004): 8-11.
  27. Hartsfield J., et al. “Genetic Factors in External Apical Root Resorption and Orthodontic Treatment”. Critical Reviews in Oral Biology and Medicine - SAGE Journals2 (2004): 115-122.
  28. Bastos Lages E., et al. “Association of Functional Gene Polymorphism Il-1beta in Patients with External Apical Root Resorption”. American Journal of Orthodontics and Dentofacial Orthopedics4 (2009): 542-546.
  29. Iglesias-Linares A., et al. “Postorthodontic External Root Resorption Is Associated with Il1 Receptor Antagonist Gene Variations”. Oral Diseases2 (2012): 198-205.
  30. Bangshun H., et al. “Interleukin 1 Beta (Il1b) Promoter Polymorphism and Cancer Risk: Evidence from 47 Published Studies”. Mutagenesis5 (2011): 637-642.
  31. Lewis A., et al. “Interleukin-1 and Cancer Progression: The Emerging Role of Interleukin-1 Receptor Antagonist as a Novel Therapeutic Agent in Cancer Treatment”. Journal of Translational Medicine 4 (2006): 48-60.
  32. Gerber J., et al. “Progressive Loss of Pax9 Expression Correlates with Increasing Malignancy of Dysplastic and Cancerous Epithelium of the Human Oesophagus”. The Journal of Pathology3 (2002): 293-297.
  33. Lammi L., et al. “Mutations in Axin2 Cause Familial Tooth Agenesis and Predispose to Colorectal Cancer”. American Journal of Human Genetics 5 (2004): 1043-1050.
  34. Schmid S., et al. “Wnt and Hedgehog Gene Pathway Expression in Serous Ovarian Cancer”. The International Journal of Gynecological Cancer6 (2011): 975-980.
  35. Iavazzo C., et al. “Hypodontia and Ovarian Cancer: A Systematic Review”. Journal Of The Turkish-German Gynecological Association1 (2016): 41-44.
  36. Song H., et al. “A Genome-Wide Association Study Identifies a New Ovarian Cancer Susceptibility Locus on 9p22.2”. Nature Genetics9 (2009): 996-1000.
  37. Dong X., et al. “Genomic Structure, Chromosome Mapping and Expression Analysis of the Human Axin2 Gene”. Cytogenetic and Genome Research1-2 (2001): 26-28.
Citation: Ghada Adel Tahoun., et al. “Dental Anomalies after Chemotherapy in Childhood Cancer Survivors: A Cross Sectional Study”. EC Dental Science 20.12 (2021): 46-53.

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