Disturbed root development of permanent teeth after pediatric stem cell transplantation

Dental root development after SCT

Authors

  • Päivi Hölttä D.D.S.,

    Corresponding author
    1. Department of Pedodontics and Orthodontics, Institute of Dentistry, University of Helsinki, Helsinki, Finland
    2. Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
    3. Division of Hematology-Oncology and Stem Cell Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
    • Institute of Dentistry, P.O. Box 41, 00014 University of Helsinki, Finland
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    • Fax: (011) 358-9-19127266

  • Liisa Hovi M.D., Ph.D.,

    1. Division of Hematology-Oncology and Stem Cell Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
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  • Ulla M. Saarinen-Pihkala M.D., Ph.D.,

    1. Division of Hematology-Oncology and Stem Cell Transplantation, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
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  • Jaakko Peltola D.D.S., Ph.D.,

    1. Department of Oral Radiology, Institute of Dentistry, University of Helsinki, Helsinki, Finland
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  • Satu Alaluusua D.D.S., Ph.D.

    1. Department of Pedodontics and Orthodontics, Institute of Dentistry, University of Helsinki, Helsinki, Finland
    2. Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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Abstract

BACKGROUND

Deficient dental root development has been reported after conventional pediatric anticancer therapy, but less information is available on stem cell transplantation (SCT) recipients.

METHODS

Root-crown (R/C) ratios of fully developed permanent teeth were assessed from panoramic radiographs of 52 SCT recipients, who were treated when they were age < 10 years. Using standard deviation scores (SDSs), the authors compared the R/C ratios to the corresponding tooth and gender-specific values in a healthy population. The percentage of affected R/C ratios per individual was examined in a subgroup of 39 (SG39) patients with advanced tooth development. The effects of total body irradiation (TBI) and SCT age on the R/C ratios were studied in TBI and high-dose chemotherapy (HDC = non-TBI) groups and in 3 age groups (≤ 3.0 years, 3.1–5.0 years, ≥ 5.1 years).

RESULTS

Per individual, 77% of the fully developed permanent teeth were affected in SG39. At the tooth level, in 77% of the 945 teeth studied (52 patients), the R/C ratios were outside ±2 SDSs. More teeth were affected in the TBI (85%) than in the non-TBI (55%) group (P < 0.001). The teeth of the patients who were ages 3.1–5.0 years old at SCT presented with the most severe aberrations of the R/C ratio (mean SDS = −4.4) whereas the teeth of the youngest (age ≤ 3.0 years) and the oldest (age ≥ 5.1 years) patients were equally affected (mean SDSs = −3.1 and −3.0, respectively).

CONCLUSIONS

Disturbances of dental root growth always followed pediatric SCT. HDC alone intensely harmed root growth but TBI further increased the adverse effects that were most extensive in the patients 3.1–5.0 years at SCT. These sequelae should be taken into account during the lifelong dental follow-up to minimize the clinical consequences of dental injuries. Cancer 2005. © 2005 American Cancer Society.

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