Dentofacial development in long‐term survivors of acute lymphoblastic leukemia: A comparison of three treatment modalities

Abstract

Ninety‐seven children who were diagnosed with acute lymphoblastic leukemia before 10 years of age and treated with chemotherapy alone, chemotherapy plus 1800‐cGy cranial irradiation (RT), or chemotherapy plus 2400‐cGy RT were evaluated for effects of therapy on dentofacial development. All patients were seen at least 5 years postdiagnosis. Dental abnormalities were determined from panoramic radiographs, and craniofacial evaluations were made from lateral cephalometric radiographs. Ninety‐one (94%) of all patients and 41 (100%) of patients younger than 5 years of age at diagnosis had abnormal dental development. the severity of these abnormalities was greater in children who received treatment before 5 years of age and in those who received RT. Observed dental abnormalities included tooth agenesis, arrested root development, microdontia, and enamel dysplasias. Craniofacial abnormalities occurred in 18 of 20 (90%) of those patients who received chemotherapy plus 2400‐cGy RT before 5 years of age. Mean cephalometric values of this group showed significant deficient mandibular development. the results of this study suggest that the severity of dentofacial‐developmental abnormalities secondary to antileukemia therapy are related to the age of the patient at the initiation of treatment and the use of cranial RT. Copyright © 1990 American Cancer Society