Avaliação dentária de pacientes pediátricos pós-tratamento oncológico para leucemia

Abstract

Introduction: Leukemia, especially acute lymphoblastic leukemia, mainly affects children and adolescents. Chemotherapy is a therapeutic modality with the best chances of cure, but it may cause adverse effects on the maxillomandibular complex. Objective: To evaluate dental abnormalities and determine the dental age of children and adolescents after oncological treatment for leukemia using panoramic radiographs. Material and methods: It is a crosssectional, retrospective, and observational study involving leukemia patients younger than 18 and treated at the Clinics Hospital of Ribeirão Preto (HCFMRP) between 2015 and 2023. The study included patients who underwent panoramic radiographs after oncological treatment and excluded those with bone deformities, facial trauma, maxillary surgeries, and low-quality or digitized images. Two dentists with an average experience of eight years and previously calibrated by a specialist with more than twenty years of experience performed the radiographic analysis. Dental abnormalities were evaluated, and dental age was determined using the Nolla and Demirjian methods. R software hosted the statistical analysis, using Student t-tests at a 5% significance level. Results: The study analyzed 93 radiographs of patients treated at the HCFMRP, with 24 referred for evaluation specifically. The sample included 19 individuals between 2 and 16 years old, with a predominance of males (63.2%) and white ethnicity (57.9%). The dental anomalies were taurodontism (52.6%), followed by microdontia (15.8%), short root (15.8%), and hypodontia (5.3%). As for dental age, the Nolla and Demirjian methods presented seven cases of dental age underestimation, while the Demirjian method had more overestimation cases (nine cases), and Nolla had five. The comparison between chronological and dental ages estimated by the Nolla and Demirjian methods revealed no significant differences. Conclusion: Pediatric patients after leukemia treatment are more likely to develop dental abnormalities and caries lesions. The oncological therapy in pediatric patients may interfere with dental age, yielding higher dental than chronological age.