Long-term Adverse Effects of Acute Myeloid Leukemia Treatment on Odontogenesis in a Child.

Childhood cancer Long-term survivors Tooth abnormalities

Journal

International journal of clinical pediatric dentistry
ISSN: 0974-7052
Titre abrégé: Int J Clin Pediatr Dent
Pays: India
ID NLM: 101585405

Informations de publication

Date de publication:
Historique:
entrez: 12 11 2019
pubmed: 12 11 2019
medline: 12 11 2019
Statut: ppublish

Résumé

Several studies showed that cancer therapies during tooth development are associated with dental abnormalities, including enamel defects, arrested tooth development, microdontic teeth, and agenesis. We describe the case of a nine-year-old boy treated for acute myeloid leukemia at 15 months of age, who presents several dental abnormalities resulting from anticancer treatment. The patient was included and treated according to the ELAM 02 French protocol. Six years after allogenic hematopoietic stem cell transplantation, the intraoral and radiographic examination highlighted the agenesis of the second permanent molars and three of the four second premolars, microdontia of the first premolars, root stunting of the central incisors and first premolars, rootlessness of the first permanent molars, and enamel defects localized at the permanent incisors and canines. As a first step to reduce enamel defects, restorations with resin composite (Tetric EvoCeram® A2, Ivoclar Vivadent) were performed under a dental dam. Orthodontic treatment was contraindicated due to arrested tooth development, short roots, and a risk of resorption is considered too important. The young age at diagnosis (<5 years of age) and intensive chemotherapy (especially myeloablative conditioning with high doses of cyclophosphamide and Busulfan) could explain the severity of the dental abnormalities. This case illustrates the importance of systematically scheduling a dental follow-up in parallel with the onco-hematologic follow-up allowing the clinicians to prevent, detect, and propose early intervention for dental late effects. Hernandez M, Pochon C,

Sections du résumé

BACKGROUND BACKGROUND
Several studies showed that cancer therapies during tooth development are associated with dental abnormalities, including enamel defects, arrested tooth development, microdontic teeth, and agenesis.
STUDY DESIGN METHODS
We describe the case of a nine-year-old boy treated for acute myeloid leukemia at 15 months of age, who presents several dental abnormalities resulting from anticancer treatment.
RESULTS RESULTS
The patient was included and treated according to the ELAM 02 French protocol. Six years after allogenic hematopoietic stem cell transplantation, the intraoral and radiographic examination highlighted the agenesis of the second permanent molars and three of the four second premolars, microdontia of the first premolars, root stunting of the central incisors and first premolars, rootlessness of the first permanent molars, and enamel defects localized at the permanent incisors and canines. As a first step to reduce enamel defects, restorations with resin composite (Tetric EvoCeram® A2, Ivoclar Vivadent) were performed under a dental dam. Orthodontic treatment was contraindicated due to arrested tooth development, short roots, and a risk of resorption is considered too important.
CONCLUSION CONCLUSIONS
The young age at diagnosis (<5 years of age) and intensive chemotherapy (especially myeloablative conditioning with high doses of cyclophosphamide and Busulfan) could explain the severity of the dental abnormalities. This case illustrates the importance of systematically scheduling a dental follow-up in parallel with the onco-hematologic follow-up allowing the clinicians to prevent, detect, and propose early intervention for dental late effects.
HOW TO CITE THIS ARTICLE UNASSIGNED
Hernandez M, Pochon C,

Identifiants

pubmed: 31708623
doi: 10.5005/jp-journals-10005-1614
pmc: PMC6811937
doi:

Types de publication

Case Reports

Langues

eng

Pagination

243-246

Informations de copyright

Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.

Déclaration de conflit d'intérêts

Source of support: Nil Conflict of interest: None

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Auteurs

Magali Hernandez (M)

Pediatric Dentistry Department, Children Hospital, CHRU Nancy, France; Pediatric Dental Department, Faculty of Dentistry, Nancy, France.

Cécile Pochon (C)

Hematology, Oncology Department, Children Hospital, CHRU Nancy, France.

Pascal Chastagner (P)

Hematology, Oncology Department, Children Hospital, CHRU Nancy, France.

Dominique Droz (D)

Pediatric Dentistry Department, Children Hospital, CHRU Nancy, France; Pediatric Dental Department, Faculty of Dentistry, Nancy, France.

Classifications MeSH