Avaliação radiomorfométrica mandibular de pacientes pediátricos com diagnóstico de leucemia

Abstract

Leukemia is one of the most common childhood cancers, often associated with intensive therapies that may significantly alter patients’ overall and oral health. This study evaluated the changes in mandibular bone microarchitecture and quality in pediatric patients diagnosed with leukemia using radiomorphometric indices such as fractal dimension and the Klemetti classification. It is a cross-sectional, retrospective, and observational study that analyzed 23 panoramic radiographs of patients diagnosed with leukemia (group Study 1) and 13 radiographs of patients treated for leukemia (group Study 2). Both groups were paired by age and sex at a ratio of 1:1 per child in group Control. The groups showed a statistically significant association with the Klemetti index (p < 0.05), as 22.2%, 39.2%, and 61.5% of patients, respectively of groups Control, Study 1, and Study 2, presented grade 2 or 3 of the Klemetti index (moderately eroded, severely eroded, or porous cortex). Considering the mean of both sides of patients, the fractal dimension below lower premolar roots was significantly smaller in groups Study 1 and 2 than in group Control (p < 0.05). The findings confirm that oncological therapy in pediatric patients significantly affects mandibular bone tissue quality, increasing the risk of complications, such as osteopenia, and challenges for future dental treatments. The radiomorphometric analysis was accessible and efficient for monitoring these changes, especially in resource-limited settings. This study highlights the need for multidisciplinary follow-up of pediatric patients with a history of leukemia, focusing on detecting late complications early and implementing preventive strategies. Also, the relevance of incorporating regular radiographic evaluations into follow-up protocols stands out, ensuring improved overall and oral health outcomes for these patients.