Case Study

Root Anomalies after Combined Chemotherapy Treatment for Acute Lymphoblastic Leukemia during Childhood: A Case Report‬‬‬‬‬‬‬‬‬‬‬‬‬

Talia Becker
Hebrew University of Jerusalem, Israel
* Corresponding author
Ella Lalum
Israel Defense Forces Medical Corps, Israel
Avi Levin
Israel Defense Forces Medical Corps, Israel
Joe Ben Itzhak
Israel Defense Forces Medical Corps, Israel
Idan Stiklaru
Israel Defense Forces Medical Corps, Israel
Michael Solomonov
Israel Defense Forces Medical Corps, Israel
DOI icon 10.24018/ejdent.2023.4.2.260

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Submitted 2023-03-12
Published 2023-04-28

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Table of Contents

Article Main Content

 Dental abnormalities have been sporadically reported in patients treated as children for acute lymphoblastic leukemia (ALL) with multi-agent chemotherapy, with and without radiation. Reports included delayed dental development, microdontia, hypoplasia, agenesis, V-shaped roots, shortened roots, and cervical root resorption. These anomalies in pediatric patients require regular dental follow-up and sometimes highly complex treatment. We describe a well-documented case of a 19-year-old male who presented with such anomalies 12 years after treatment with several chemotherapy agents for ALL, and discuss the resultant disruption of normal tooth development that led to the ensuing abnormalities.

Keywords: Acute lymphoblastic leukemia dental abnormalities multi-agent chemotherapy shortened roots tooth development

References

  1. Minicucci EM, Lopes LF, Crocci AJ. Dental abnormalities in children after chemotherapy treatment for acute lymphoid leukemia. Leuk Res. 2003; 27: 45-50.
     Google Scholar
  2. Llavayol M, Pons M, Ballester ML, Berástegui E. Multiple cervical root resorption in a young adult female previously treated with chemotherapy: a case report. Journal of Endodontics. 2019; 45(3): 349-53.
     Google Scholar
  3. Maciel JC, de Castro C G Jr, Brunetto AL, Leone LCD, de Silveira HED. Oral health and dental anomalies in patients treated for leukemia in childhood and adolescence. Pediatr Blood Cancer. 2009; 53: 361-365.
     Google Scholar
  4. Dahllöf G, Rozell B, Forsberg CM, Borgström B. Histologic changes in dental morphology induced by high dose chemotherapy and total body irradiation. Oral Surgery, Oral Medicine, Oral Pathology. 1994; 77(1): 56-60.
     Google Scholar
  5. Pui C H, Campana D, Evans WE. Childhood acute lymphoblastic leukaemia-current status and future perspectives. Lancet Oncol. 2001; 2: 597-607.
     Google Scholar
  6. Nemeth O, Hermann P, Kivovics P, Garami M. Long-term effects of chemotherapy on dental status of children cancer survivors. Pediatric Hematology and Oncology. 2013;30(3):208-15.
     Google Scholar
  7. Macleod RI, Welbury RR, Soames JV. Effects of cytotoxic chemotherapy on dental development. J R Soc Med. 1987; 80: 207-209.
     Google Scholar
  8. Cho SY, Cheng AC, Cheng MC. Oral care for children with leukaemia. Hong Kong Med J. 2000; 6: 203-208.
     Google Scholar
  9. Shacham M, Levin A, Shemesh A, Lvovsky A, Ben Itzhak J, Solomonov M. Accuracy and stability of electronic apex locator length measurements in root canals with wide apical foramen: an ex vivo study. BDJ Open. 2020; 6(1): 22.
     Google Scholar
  10. Abbott, PV, Yu C. A clinical classification of the status of the pulp and the root canal system. Aust Dent J . 2007; 52: S17-S31.
     Google Scholar
  11. Oliet S, Grossman LI, eds. Diagnosis and Treatment of Endodontic Emergencies, Vol. 1. Chicago: Quintessence Publishing Company, 1981.
     Google Scholar
  12. Nishimura S, Inada H, Sawa Y, Ishikawa H. Risk factors to cause tooth formation anomalies in chemotherapy of paediatric cancers. European Journal of Cancer Care. 2013; 22(3): 353-60.
     Google Scholar
  13. Avşar A, Elli M, Darka Ö, Pinarli G. Long-term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007; 104(6): 781-9.
     Google Scholar
  14. Kinirons MJ, Fleming P, Boyd D. Dental caries experience of children in remission from acute lymphoblastic leukaemia in relation to the duration of treatment and the period of time in remission. Int J Paediatr Dent . 1995; 5: 169-172.
     Google Scholar
  15. Pajari U, Lanning M, Larmas M. Prevalence and location of enamel opacities in children after anti-neoplastic therapy. Community Dent Oral Epidemiol. 1988; 16: 222-226.
     Google Scholar
  16. Kaste SC, Hopkins KP, Jones D, Crom D, Greenwald CA, Santana VM. Dental abnormalities in children treated for acute lymphoblastic leukemia. Leukemia. 1997; 11(6): 792-6.
     Google Scholar
  17. Goho C. Chemoradiation therapy: effect on dental development. Pediatr Dent. 1993; 15: 6-12.
     Google Scholar
  18. Cubukçu CE, Sevinir B. Dental health indices of long-term childhood cancer survivors who had oral supervision during treatment: a case-control study. Pediatr Hematol Oncol. 2008; 25: 638-646.
     Google Scholar
  19. Nunn JH, Welbury RR, Gordon PH, Kernahan J, Craft AW. Dental caries and dental anomalies in children treated by chemotherapy for malignant disease: a study in the north of England. Int J Paediatr Dent. 1991; 1: 131-135.
     Google Scholar
  20. Laux M, Abbott PV, Pajarola G, Nair PN. Apical inflammatory root resorption: a correlative radiographic and histological assessment. International Endodontic Journal. 2000; 33(6): 483-93.
     Google Scholar