Dental maturity assessment in children with acute lymphoblastic leukemia after cancer therapy

• Published in: Forensic science international Vol. 184; no. 1; pp. 10 - 14
• Main Authors: Vasconcelos, Niucha P.S., Caran, Eliana M.M., Lee, Maria Lucia, Lopes, Nilza N.F., Weiler, Rosa M.E.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 30.01.2009; Elsevier; Elsevier Limited
• Subjects: Age Determination by Teeth; Age estimation; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Biological and medical sciences; Case-Control Studies; Child; Child, Preschool; Chronological age; Dental age; Female; Forensic Dentistry; Forensic medicine; Forensic sciences; General aspects; Humans; Investigative techniques, diagnostic techniques (general aspects); Leukemia; Male; Medical sciences; Pathology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy; Public health. Hygiene; Public health. Hygiene-occupational medicine; Radiography, Panoramic; Tooth - drug effects; Tooth - growth & development; Tooth - radiation effects; Tooth Root - drug effects; Tooth Root - growth & development; Tooth Root - radiation effects; ALL; GRAACC; Age estimation; Leukemia; Chronological age; BMT; IOP; Dental age; UNIFESP; APCD; institute of pediatric oncology (in São Paulo, Brazil); bone marrow transplant; grupo de apoio a adolescentes e crianças com câncer (support group for teenagers and children with cancer in São Paulo, Brazil); universidade federal de São Paulo (Federal University of São Paulo, Brazil); acute lymphoblastic leukemia; associação paulista de cirurgiões dentistas (Dentists Association of São Paulo, Brazil); Human; Forensic science; Legal medicine; Malignant hemopathy; Forensic aspect; Malignant tumor; Treatment; Forensic odontology; Lymphoproliferative syndrome; Tooth; Acute lymphocytic leukemia; Child; Age; Maturity; Cancer
• ISSN: 0379-0738; 1872-6283; 1872-6283
• DOI: 10.1016/j.forsciint.2008.11.009

Dental age is largely used in both forensic studies and clinical practice. All over the world, many studies have been made to determine chronological age using dental ages of individuals, but selecting individuals with no chronic or acute sickness as the study group. Cancer is the second most frequent cause of death in children, and acute lymphoblastic leukemia (ALL) is the most common type of cancer in childhood. Most of the children who survived childhood cancer experienced disturbances in dental development due to cancer therapy or to cancer itself. The aim of this study is to assess dental development in children and teenagers who had suffered from childhood leukemia and were submitted to chemotherapy isolated or associated with radiotherapy, by comparing the dental ages with those corresponding features in a healthy control group. Dental development was analyzed using panoramic radiographs of 92 children divided in two groups: 46 children between 5 and 12 years old, treated for ALL at GRAACC – IOP, UNIFESP, and as a control group, 46 healthy children treated for dental reasons at APCD, São Paulo. The dental age of the subjects was estimated using the system of Demirjian et al. [A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45(2) (1973) 211–227]. A significant difference was found between the chronological and dental age of patients submitted to antineoplasic therapy for ALL, when compared to those of the control group, but there were no significant differences between patients treated with different protocols for ALL. Conclusions: although the study was within a small group of patients, we could clearly conclude that antineoplastic therapy can interfere in the dental maturity of patients treated for childhood cancer by interfering in dental formation and root development.