Uderzo C, Fraschini D, Balduzzi A, Galimberti S, Arrigo C, Biagi E, Pignanelli M, Nicolini B, Rovelli A
Clinica Pediatrica dell'Università di Milano, Ospedale S Gerardo, Monza, Milan, Italy.
Bone Marrow Transplant. 1997 Nov;20(10):865-9. doi: 10.1038/sj.bmt.1700993.
Minimal data about oral and dental health in long-term survivors after BMT are available. We studied the dental status of 27 children (19 males, eight females) with leukaemia, followed up with a routine oral examination, panoramic tomogram and, when necessary, an endoral radiograph at a median of 2 years (range 1-10) after BMT. Community periodontal index treatment necessity (CPITN), dental caries, missing or filled permanent teeth (DMFT) and dento-facial alterations according to WHO criteria were registered and evaluated. Median age of the patients at BMT was 9 years (range 1.1-17.9). The mean DMFT score ranged from 1.6 to 12.4 according to age at examination and was slightly higher than that which we previously reported in children who received chemotherapy alone. CPITN showed the presence of soft deposits in 77.7%, serious gingivitis in 59.2% and parodontal involvement in 3.7% of cases. Dento-facial abnormalities were found in 55.5% of patients, while 62.9% of the patients had tooth abnormalities or agenesis. Nine out of 27 patients (33%) had root hypoplasia. A negative impact on DMFT index due to multiple post-BMT factors was found. Age is the crucial factor in determining a developmental defect of enamel and root. The follow-up of long-term survivors after BMT should include regular dental examination.
关于骨髓移植（BMT）后长期存活者口腔和牙齿健康的可用数据极少。我们研究了27例白血病患儿（19例男性，8例女性）的牙齿状况，在BMT后中位时间2年（范围1 - 10年）进行常规口腔检查、全景断层扫描，必要时进行口腔内X光检查。根据世界卫生组织标准记录并评估社区牙周指数治疗必要性（CPITN）、龋齿、恒牙缺失或充填情况（DMFT）以及牙面改变。患者接受BMT时的中位年龄为9岁（范围1.1 - 17.9岁）。根据检查时的年龄，平均DMFT评分在1.6至12.4之间，略高于我们之前报道的仅接受化疗的儿童。CPITN显示77.7%的病例存在软垢，59.2%有严重牙龈炎，3.7%有牙周受累。55.5%的患者存在牙面异常，62.9%的患者有牙齿异常或缺失。27例患者中有9例（33%）有牙根发育不全。发现多种BMT后因素对DMFT指数有负面影响。年龄是决定牙釉质和牙根发育缺陷的关键因素。BMT后长期存活者的随访应包括定期牙科检查。
