Evaluation of Permanent Tooth Development in Pediatric Cancer Survivors: A Single Center Experience

Abstract

Aim: Childhood cancer survival has improved significantly with advances in multimodal treatment. However, treatment-related long-term side effects, including dental developmental abnormalities, remain a concern. The aim of this study was to investigate permanent tooth development and associated risk factors in childhood cancer survivors who were treated before the age of six years, focusing on non-leukemia cases. Materials and Methods: This study was conducted on childhood cancer cases treated with chemotherapy and/or radiotherapy at a single center. Patients diagnosed before the age of six and who were twelve or above at the time of assessment were included. Dental examinations, including Decayed, Missing, Filled Teeth index and radiographic assessments, were performed. Statistical analyses were performed in order to identify associations between treatment modalities and dental findings. Results: Of 914 patients, 90 met the inclusion criteria, with 35 participating in this study. The mean age at diagnosis was four years, with a mean follow-up duration of ten years. Root shortening, hypoplasia, and hypodontia were observed to be common dental anomalies. There was a significant association between alkylating agents, vinca alkaloid plus alkylating agents and root shortening (p<0.001, p<0.001). No significant differences in dental findings were found based on gender, tumor site, or other treatment modalities (p<0.05). As the age at diagnosis increased, the risk of root shortening (p=0.026) and the frequency of hypodontia significantly increased with the duration after diagnosis (p=0.048). Conclusion: Childhood cancer survivors treated during early dentition periods are at risk of dental developmental anomalies, with alkylating agents showing the most significant impact. This emphasizes the necessity of providing these patients and their families with information on the importance of maintaining oral and dental health during and after cancer treatment.

Keywords

• childhood
• cancer
• dental health