Impact of Hematopoietic Stem Cell Transplantation on Dental Development

Biol Blood Marrow Transplant. 2019 Jan;25(1):107-113. doi: 10.1016/j.bbmt.2018.08.027. Epub 2018 Sep 4.

Abstract

To investigate dental development in patients treated with a hematopoietic stem cell transplantation (HSCT), 42 children and young adults who were under 12 years old at time of HSCT were examined for dental agenesis, microdontia, and root-to-crown ratio. Conditioning regimens were total body irradiation (TBI) based in 12 patients, busulfan based in 21 patients, and 9 patients had other chemotherapeutic agents. Sixteen patients were <3 years old, 9 patients were 3 to 6 years old, and 17 patients were 6 to 12 years old at HSCT. Prevalence of agenesis and microdontia of at least 1 permanent tooth were, respectively, 51.3% and 46.2% in the study population, and 76.3% had an aberrant root-to-crown ratio. All these results were highly different from the prevalence in the healthy population. Patients treated before the age of 3 years had more microdontia (76.9%) and agenesis (92.3%) compared with patients treated at an older age. In the subgroup of patients treated after 6 years, there was more microdontia when treated with busulfan (50%) compared with treatment with TBI (0%) (P = .044). Patients treated with HSCT had many disturbances in dental development. Age at HSCT and possibly also the conditioning regimen used had an effect on their type and prevalence. Dental follow-up should be incorporated in the multidisciplinary follow-up program of these patients.

Keywords: Busulfan; Dental development; Hematopoietic stem cell transplantation; Late side effects; Total body irradiation.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Allografts
  • Busulfan / administration & dosage
  • Busulfan / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Male
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Risk Factors
  • Tooth / growth & development*
  • Tooth / pathology
  • Transplantation Conditioning*
  • Whole-Body Irradiation / adverse effects

Substances

  • Busulfan