Dental

Dental abnormalities are common in childhood cancer survivors. Both chemotherapy and radiation therapy can disrupt normal odontogenesis, especially in patients younger than 5 years (Sonis et al. 1990). Head and neck irradiation has been shown to increase dental injury (Sonis et al. 1990; Hölttä et al. 2002; Estilo et al. 2003). Two studies focused on the dental problems observed in neuroblastoma patients. In a cohort of 52 patients, Kaste et al. (1998) reported an incidence of 71% dental abnormalities including microdontia (38%), excessive caries (29%), root stunting, hypo-dontia, and enamel hypoplasia. Hölttä et al. (2002) studied a group of high-risk neuroblastoma patients treated with autologous stem-cell transplantation. Among patients who received TBI as a part of the conditioning regimen, dental abnormalities were more severe than those receiving non-TBI regimens. These results suggest that intensive treatment at a young age can affect teeth development, resulting in severe malocclusion, as well as other long-term dentofacial problems. Close attention to oral hygiene and regular dental care are, therefore, mandatory in all neuroblastoma survivors.

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