Näsman M, Forsberg C M, Dahllöf G
Department of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Stockholm, Sweden.
Eur J Orthod. 1997 Apr;19(2):151-9. doi: 10.1093/ejo/19.2.151.
A radiographic dental examination was performed in 16 children conditioned with total body irradiation (TBI) and cyclophosphamide (CY) prior to bone marrow transplantation (BMT), and in 52 children treated with multiagent chemotherapy. For each child, three age- and sex-matched healthy controls were selected. Evaluation of disturbances in dental development and tooth size was based on planimetric measurements of mandibular teeth on panoramic radiographs. Short V-shaped roots were diagnosed in 94 per cent of the children treated with TBI/CY compared with 19 per cent in the chemotherapy group (P < 0.001). Children receiving TBI/CY also exhibited a pronounced reduction in tooth size compared with the controls. Reductions varied from 19 per cent in incisors to 39 per cent in the second molars. In the chemotherapy group the corresponding values were 7 and 15 per cent respectively. When comparing crown/root ratios, the indices for incisors, canines (P < 0.05) and molars (P < 0.01) in the BMT group were significantly higher than the corresponding values in the control group. This indicates that the reduction in root size was more pronounced than the reduction in crown size. The premolars in the BMT group exhibited a similar reduction in crown and root size. All developing teeth were affected by multiagent chemotherapy and radiation therapy. The most severe disturbances were found in children treated with TBI/CY at a young age.
对16名在骨髓移植（BMT）前接受全身照射（TBI）和环磷酰胺（CY）治疗的儿童以及52名接受多药化疗的儿童进行了牙科X线检查。为每名儿童挑选了3名年龄和性别匹配的健康对照。基于全景X线片上对下颌牙齿的平面测量来评估牙齿发育和牙齿大小的紊乱情况。接受TBI/CY治疗的儿童中有94%被诊断出牙根呈短V形，而化疗组这一比例为19%（P<0.001）。与对照组相比，接受TBI/CY治疗的儿童牙齿大小也明显减小。减小幅度从切牙的19%到第二磨牙的39%不等。化疗组的相应数值分别为7%和15%。比较冠根比时，骨髓移植组切牙、尖牙（P<0.05）和磨牙（P<0.01）的指数显著高于对照组的相应数值。这表明牙根大小的减小比牙冠大小的减小更明显。骨髓移植组的前磨牙牙冠和牙根大小也有类似程度的减小。所有正在发育的牙齿都受到多药化疗和放射治疗的影响。最严重的紊乱情况出现在年幼时接受TBI/CY治疗的儿童中。
