Duration and dose of chemotherapy and dental development

Abstract

The study aimed to establish an anticancer drug- and its dose-dependency of long-term adverse dental effects occurrence in cancer survivors. The objective of the research was a dental examination with a thorough analysis of panoramic radiographs in 37 cancer survivors treated with antineoplastic therapy before 10 year of age and at least 2 years after therapy completion. A total of 236 teeth with 243 different developmental abnormalities were revealed. Twenty-eight survivors presented with 236 teeth with 243 developmental abnormalities, such as agenesis, tooth size reduction, taurodontia and enamel and root abnormalities. All the survivors received multiagent chemotherapy with the most frequent use of VCR, DXR, CP, IF, VP-16, CBDCA, CDDP, ACTD. A detailed analysis of medical records in order to assess a relationship between treatment duration and cumulative drug doses administered and occurrence of particular disturbances was also performed. There were no statistically significant differences between survivors with different disturbances within almost all particular drug groups when analyzing treatment duration and drug doses in the affected and non-affected participants. In some groups the mean cumulative treatment dose was statistically significantly higher in the non-affected patients. According to Spearman's rho, no reasonable relationship can be confirmed. With respect to different treatment protocols used an analysis of a more homogenous group of survivors seems necessary. The developmental stage of tooth formation during chemotherapy is likely to be the most important decisive factor for dental changes.