Original Article
Orthodontic treatment in long-term survivors after pediatric bone marrow transplantation*,**,*,**,*

https://doi.org/10.1067/mod.2001.118102Get rights and content

Abstract

Children treated for childhood cancers with both radiation and chemotherapy often exhibit disturbances in dental development. A retrospective analysis of treatment outcome in 10 orthodontically treated children was performed. A questionnaire was sent to each child's orthodontist, and 5 orthodontists reported that the patient's medical condition influenced their choice of treatment plan. Three orthodontists, all treating patients with severely disturbed root development, reported using lighter forces than they used with the average patient. With regard to complications related to orthodontic treatment, 1 of the 10 patients showed evidence of root resorption. In 4 of the 10 patients, the treatment result was judged to be unsatisfactory. This study showed that, although ideal treatment results were not always achieved, orthodontic treatment did not produce any harmful side effects in children who are long-term survivors of childhood cancer. (Am J Orthod Dentofacial Orthop 2001;120:459-65)

Section snippets

Material and methods

From 1975 to 1995, 190 children (< 12 years of age) were treated with BMT at Huddinge University Hospital in Sweden. Details of their medical and dental treatments have been reported by Näsman et al.19 Of these children, 106 survived more than 2 years. All the children had an oral examination before BMT and then annually in the Department of Pediatric Dentistry, Karolinska Institutet in Stockholm. The children came from all parts of Sweden, and their dental treatments were performed at local

Results

Generally, very few harmful effects as a result of orthodontic therapy were reported in these children with severe disturbances in dental development. Five orthodontists reported that the choice of therapy and the treatment plan were influenced by the patient's condition. The patients had all been treated with 10 Gy TBI and exhibited the most severe disturbances in root development. Orthodontic treatments for 3 patients were delayed because of their previous medical conditions. One orthodontist

Discussion

Disturbed dental development in children treated with BMT has been reported in several studies, but information about orthodontic treatment outcomes in these patients is still lacking. This information is urgently needed, because the population of long-term survivors after pediatric malignancies is increasing. With the treatment protocols available today, about 85% of children less than 15 years of age diagnosed with cancer survive at least 5 years.24

Long-term survivors of BMT, particularly

Acknowledgements

We thank these contributing orthodontists: Christer Engström, Gällivare; Anders Fischer, Nyköping; Carl-Magnus Forsberg, Stockholm; Sven Glantz, Eskilstuna; Bernt-Arne Larsson, Luleå; Gösta Lindgren, Kristianstad; Ulf Ljungberg, Skeppslanda; Ola Mörndal, Västerås; Bengt Schön, Arvika; and Håkan Westerling, Kalmar.

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    *

    Supported by grants from the Swedish Children's Cancer Foundation and the Swedish Medical Research Council.

    **

    aProfessor of Pediatric Dentistry.

    *

    bPostgraduate student, Pediatric Dentistry.

    **

    cVisiting Professor of Orthodontics, from the Department of Preventive Dentistry, National University of Singapore.

    *

    Reprint requests to: G. Dahllöf, Department of Pediatric Dentistry, Karolinska Institutet, PO Box 4064, SE 141 04, Huddinge, Sweden; e-mail, [email protected].

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