Dental and maxillofacial outcomes in childhood head and neck cancer survivors: a retrospective study and dental care considerations

Autores

DOI:

https://doi.org/10.5327/2525-5711.246

Palavras-chave:

Cancer Survivors, Long-Term, Radiotherapy, Chemotherapy, Maxillofacial Abnormalities

Resumo

Cancer treatment during childhood, including head and neck radiotherapy and chemotherapy, can cause persistent dental and
maxillofacial changes, which may lead to long-term complications in dental care and oral rehabilitation. Objective: The aim
of this study was to evaluate dental and maxillofacial alterations resulting from childhood head and neck cancer treatment and
discuss considerations regarding dental care for these patients. Methods: This retrospective study utilized a Cancer Center
database, including patients referred to the Stomatology Department from 2004 to 2018. Results: The sample comprised 12
patients (7 males and 5 females) with a mean age of 5 years at diagnosis, who underwent oncological treatment in the head and
neck region. Half exhibited facial bone hypoplasia, predominantly mandibular (33.33%) over maxillary (16.67%). Nearly all
patients showed dental abnormalities, including agenesis (50%), supernumerary teeth (16.67%), and root formation anomalies
(66%). Conclusion: This study underscores the importance of understanding these treatment-related alterations to ensure
appropriate dental care for these patients. The involvement of a dental surgeon is crucial to providing comprehensive care and
effectively monitoring any dental and maxillofacial complications.

Biografia do Autor

Kaio Heide Sampaio Nobrega, A.C. Camargo Cancer Center, Stomatology – São Paulo (SP), Brazil.

Resident in Oral Medicine at Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil

Riéli Elis Schulz, A.C. Camargo Cancer Center, Stomatology – São Paulo (SP), Brazil.

Residency in Stomatology at the Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil

Currently PhD student in a post-graduation program in oral diagnosis at the Federal University of Santa Catarina.

Fabio Abreu Alves, A.C. Camargo Cancer Center, Stomatology – São Paulo (SP), Brazil.

Head of Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil

Cecilia Maria Lima da Costa, A.C.Camargo Cancer Center, Pediatric Oncology – São Paulo (SP), Brazil.

Department of Pediatric Oncology, A.C.Camargo Cancer Center, São Paulo, SP, Brazil

Juliane Piragine Araujo, A.C. Camargo Cancer Center, Stomatology – São Paulo (SP), Brazil.

Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil

Referências

Kaatsch P. Epidemiology of childhood cancer. Cancer

Treat Rev. 2010;36(4):277-85. https://doi.org/10.1016/j.

ctrv.2010.02.003

Darzy KH, Shalet SM. Radiation-induced growth hormone

deficiency. Horm Res. 2003;59(Suppl 1):1-11. https://doi.

org/10.1159/000067834

Mattos VD, Ferman S, Magalhães DMA, Antunes HS, Lourenço

SQC. Dental and craniofacial alterations in long-term survivors

of childhood head and neck rhabdomyosarcoma. Oral Surg

Oral Med Oral Pathol Oral Radiol. 2019;127(4):272-81. https://

doi.org/10.1016/j.oooo.2018.12.012

Seremidi K, Kloukos D, Polychronopoulou A, Kattamis A,

Kavvadia K. Late effects of chemo and radiation treatment on

dental structures of childhood cancer survivors. A systematic

review and meta-analysis. Head Neck. 2019;41(9):3422-33.

https://doi.org/10.1002/hed.25840

Hancock PJ, Epstein JB, Sadler GR. Oral and dental

management related to radiation therapy for head and neck

cancer. J Can Dent Assoc. 2003;69(9):585-90. PMID: 14653934.

Seremidi K, Kavvadia K, Kattamis A, Polychronopoulou A.

Dental late effects of antineoplastic treatment on childhood

cancer survivors: radiographic findings. Int J Paediatr Dent.

;31(6):742-51. https://doi.org/10.1111/ipd.12792

Milgrom SA, van Luijk P, Pino R, Ronckers CM, Kremer

LC, Gidley PW, et al. Salivary and dental complications in

childhood cancer survivors treated with radiation therapy to

the head and neck: a PENTEC comprehensive review. Int

J Radiat Oncol Biol Phys. 2024;119(2):467-81. https://doi.

org/10.1016/j.ijrobp.2021.04.023

Nolla CM. The development of the permanent teeth. J Dent

Child. 1960;27(2):254-66.

Journal of Oral Diagnosis 2024

Arboleda LPA, Mendonça RMH, Lopez EEM, Araújo ALD,

Palmier NR, Paglioni MP, et al. Global frequency and

distribution of head and neck cancer in pediatrics, a systematic

review. Crit Rev Oncol Hematol. 2020;148:102892. https://doi.

org/10.1016/j.critrevonc.2020.102892

Dahllöf G, Huggare J. Orthodontic considerations in

the pediatric cancer patient: a review. Semin Orthod.

;10(4):266-76. https://doi.org/10.1053/j.sodo.2004.09.007

Çetiner D, Çetiner S, Uraz A, Alpaslan GH, Alpaslan C,

Memikoğlu TUT, et al. Oral and dental alterations and

growth disruption following chemotherapy in long-term

survivors of childhood malignancies. Support Care Cancer.

;27(5):1891-9. https://doi.org/10.1007/s00520-018-4454-0

Gevorgyan A, La Scala GC, Neligan PC, Pang CY, Forrest CR.

Radiation-induced craniofacial bone growth disturbances. J

Craniofac Surg. 2007;18(5):1001-7. https://doi.org/10.1097/

scs.0b013e31812f7584

Milgrom SA, van Luijk P, Pino R, Ronckers CM, Kremer

LC, Gidley PW, et al. Salivary and dental complications in

childhood cancer survivors treated with radiation therapy to

the head and neck: a PENTEC comprehensive review. Int

J Radiat Oncol Biol Phys. 2024;119(2):467-81. https://doi.

org/10.1016/j.ijrobp.2021.04.023

Kang CM, Hahn SM, Kim HS, Lyu CJ, Lee JH, Lee J, et al.

Clinical risk factors influencing dental developmental

disturbances in childhood cancer survivors. Cancer Res Treat.

;50(3):926-35. https://doi.org/10.4143/crt.2017.296

Dahllöf G, Rozell B, Forsberg CM, Borgström B. Histologic

changes in dental morphology induced by high dose

chemotherapy and total body irradiation. Oral Surg Oral Med

Oral Pathol. 1994;77(1):56-60. https://doi.org/10.1016/s0030-

(06)80107-6

Stolze J, Vlaanderen KCE, Holtbach FCED, Teepen JC, Kremer

LCM, Loonen JJ, et al. Long-term effects of childhood cancer

treatment on dentition and oral health: a dentist survey

study from the DCCSS LATER 2 study. Cancers (Basel).

;13(21):5264. https://doi.org/10.3390/cancers13215264

Satoh H, Uesugi Y, Kawabata T, Mori K, Fujii F, Kashimoto Y,

et al. Morphological classification of dental lesions induced

by various antitumor drugs in mice. Toxicol Pathol. 2001

;29(3):292-9. https://doi.org/10.1080/019262301316905246

Goho C. Chemoradiation therapy: effect on dental

development. Pediatr Dent. 15(1):6-12. PMID: 8233995.

Duggal MS. Root surface areas in long-term survivors of

childhood cancer. Oral Oncol. 2003 Feb;39(2):178-83. https://

doi.org/10.1016/s1368-8375(02)00089-1

Jensen JS, Grønhøj C, Kjær EKR, Charabi BW, von Buchwald C,

Hjuler T. Second primary cancers in pediatric head and neck

cancer survivors in Denmark during 1980–2014: a nationwide

study. Int J Pediatr Otorhinolaryngol. 2019;127:109648. https://

doi.org/10.1016/j.ijporl.2019.109648

Delanian S, Lefaix JL. Mature bone radionecrosis: from

recent physiopathological knowledge to an innovative

therapeutic action. Cancer Radiother. 2002;6(1):1-9. https://

doi.org/10.1016/s1278-3218(01)00142-1

Mercier JM, Perrin JP, Longis J, Arzul L, Corre P. Facial

asymmetries and their skeletal component. Rev Stomatol

Chir Maxillofac Chir Orale. 2014;115(4):219-28. https://doi.

org/10.1016/j.revsto.2014.07.004

Effinger KE, Migliorati CA, Hudson MM, McMullen KP, Kaste

SC, Ruble K, et al. Oral and dental late effects in survivors

of childhood cancer: a Children’s Oncology Group report.

Support Care Cancer. 2014;22(7):2009-19. https://doi.

org/10.1007/s00520-014-2260-x

Seremidi K, Gizani S, Dahllöf G, Barr-Agholme M, Kloukos D,

Tsilingaridis G. Dental management of long-term childhood

cancer survivors: a systematic review. Eur Arch Paediatr Dent.

https://doi.org/10.1007/s40368-024-00896-5

Chang PC, Lin SY. A long-term follow-up of dental and

craniofacial disturbances after cancer therapy in a pediatric

rhabdomyosarcoma patient: case report. Int J Environ Res

Public Health. 2021;18(22):12158. https://doi.org/10.3390/

ijerph182212158

Kotsiomiti E, Kolokitha OE, Lazaridis N. Interim prosthodontic

management of surgery-induced dental agenesis: a clinical

report of 8 years of treatment. J Prosthodont. 2013;22(5):408-

https://doi.org/10.1111/jopr.12013

King E. Oral sequelae and rehabilitation considerations for

survivors of childhood cancer. Br Dent J. 2019;226(5):323-9.

https://doi.org/10.1038/s41415-019-0043-y

Chambrone L, Mandia jr J, Shibli JA, Romito GA, Abrahao

M. Dental implants installed in irradiated jaws: a systematic

review. J Dent Res. 2013;92(12 Suppl):119S-30S. https://doi.

org/10.1177/0022034513504947

Ortigara GB, Bonzanini LIL, Schulz RE, Ferrazzo KL. Late

radiation effects in survivors of head and neck cancer: state

of the science. Crit Rev Oncol Hematol. 2021;162:103335.

https://doi.org/10.1016/j.critrevonc.2021.103335

Nemeth O, Kivovics M, Pinke I, Marton K, Kivovics P, Garami

M. Late effects of multiagent chemotherapy on salivary secretion

in children cancer survivors. J Am Coll Nutr. 2014;33(3):186-91.

https://doi.org/10.1080/07315724.2013.834802

Publicado

2024-11-05

Como Citar

1.
Sampaio Nobrega KH, Schulz RE, Alves FA, Lima da Costa CM, Araujo JP. Dental and maxillofacial outcomes in childhood head and neck cancer survivors: a retrospective study and dental care considerations. J Oral Diagn [Internet]. 5º de novembro de 2024 [citado 15º de novembro de 2024];9. Disponível em: https://joraldiagnosis.com/revista/article/view/246

Edição

Seção

Artigo Original