Jaffe N, Toth B B, Hoar R E, Ried H L, Sullivan M P, McNeese M D
Pediatrics. 1984 Jun;73(6):816-23.
Sixty-eight long-term survivors of childhood cancer were evaluated for dental and maxillofacial abnormalities. Forty-five patients had received maxillofacial radiation for lymphoma, leukemia, rhabdomyosarcoma, and miscellaneous tumors. Forty-three of the 45 patients and the remaining 23 who had not received maxillofacial radiation also received chemotherapy. Dental and maxillofacial abnormalities were detected in 37 of the 45 (82%) radiated patients. Dental abnormalities comprised foreshortening and blunting of roots, incomplete calcification, premature closure of apices, delayed or arrested tooth development, and caries. Maxillofacial abnormalities comprised trismus, abnormal occlusal relationships, and facial deformities. The abnormalities were more severe in those patients who received radiation at an earlier age and at higher dosages. Possible chemotherapeutic effects in five of 23 patients who received treatment for tumors located outside the head and neck region comprised acquired amelogenesis imperfecta, microdontia of bicuspid teeth, and a tendency toward thinning of roots with an enlarged pulp chamber. Dental and maxillofacial abnormalities should be recognized as a major consequence of maxillofacial radiation in long-term survivors of childhood cancer, and attempts to minimize or eliminate such sequelae should involve an effective interaction between radiation therapists, and medical and dental oncologists.
对68名儿童癌症长期幸存者进行了口腔颌面部异常评估。45名患者因淋巴瘤、白血病、横纹肌肉瘤和其他肿瘤接受了颌面部放疗。这45名患者中的43名以及其余23名未接受颌面部放疗的患者也接受了化疗。在45名接受放疗的患者中，有37名（82%）检测到口腔颌面部异常。牙齿异常包括牙根缩短和变钝、钙化不完全、根尖过早闭合、牙齿发育延迟或停滞以及龋齿。口腔颌面部异常包括牙关紧闭、咬合关系异常和面部畸形。在年龄较小和接受较高剂量放疗的患者中，这些异常更为严重。23名接受头颈部以外肿瘤治疗的患者中有5名可能的化疗影响包括获得性牙釉质发育不全、双尖牙过小牙以及牙根变薄伴髓腔扩大的趋势。口腔颌面部异常应被视为儿童癌症长期幸存者颌面部放疗的主要后果，并且尽量减少或消除此类后遗症的尝试应涉及放疗师、医学肿瘤学家和牙科肿瘤学家之间的有效互动。
