Complicaciones a largo plazo en el desarrollo dentario de pacientes pediátricos posterior al tratamiento oncológico: Una revisión sistemática

Francisca Gamboa Arellano; Juan Pablo  Aitken Saavedra; Fernanda Troncozo Encina; Gina Pennacchiotti Vidal; Carolina Arriagada Vargas

doi:10.47990/z67n3841

Autores

Francisca Gamboa Arellano Universidad de Chile, Santiago, Chile https://orcid.org/0000-0002-2301-6502
Juan Pablo Aitken Saavedra Universidad de Chile, Santiago, Chile https://orcid.org/0000-0002-2525-8433
Fernanda Troncozo Encina Universidad de Chile, Santiago, Chile https://orcid.org/0009-0001-9668-8502
Gina Pennacchiotti Vidal Universidad de Chile, Santiago, Chile https://orcid.org/0009-0003-6898-929X
Carolina Arriagada Vargas Universidad de Chile, Santiago, Chile https://orcid.org/0000-0001-7167-1598

DOI:

https://doi.org/10.47990/z67n3841

Palavras-chave:

câncer infantil, tratamento antineoplásico, manifestações do desenvolvimento dentário

Resumo

Introdução e objetivos: O câncer infantil é uma doença rara que afeta crianças e adolescentes com menos de 19 anos, sendo uma das principais causas de mortalidade no mundo. O aumento na taxa de sobrevivência tem levado ao surgimento de sequelas decorrentes do tratamento oncológico. O objetivo desta revisão foi descrever as complicações no desenvolvimento dentário deste grupo após o tratamento antineoplásico. Metodologia: Foi realizada uma busca em bases de dados eletrônicas e uma revisão manual para identificar estudos relevantes. Foram incluídos estudos de coorte, transversais e de caso-controle publicados nos últimos 20 anos em inglês, espanhol e português. A estratégia de busca combinou termos MeSH e palavras livres. Seguindo a estratégia PICO, foram selecionados artigos que avaliaram pacientes de 0 a 19 anos com câncer infantil tratados com quimioterapia, radioterapia, cirurgia, transplante de células hematopoiéticas e terapias combinadas. O desfecho avaliado foi a presença de manifestações a longo prazo no desenvolvimento dentário após o tratamento oncológico. Resultados: De 116 estudos, foram selecionados 21. Os desenhos metodológicos estavam distribuídos igualmente (33,3% cada). A leucemia foi o câncer infantil mais frequente (40,3%). A maioria dos pacientes recebeu quimioterapia exclusiva (71,6%) e as principais alterações dentárias foram malformações radiculares (26,1%), hipoplasia do esmalte (24,8%), microdontia (24,6%) e agenesia dentária (17,8%). Conclusão: As terapias antineoplásicas em pacientes oncopediátricos estão associadas a alterações dentárias. A integração do cirurgião-dentista na equipe interdisciplinar é fundamental para prevenir, diagnosticar e tratar essas manifestações.

Biografia do Autor

Gina Pennacchiotti Vidal, Universidad de Chile, Santiago, Chile

C

Referências

1. Kyu HH, Stein CE, Boschi Pinto C, Rakovac I, Weber MW, Dannemann Purnat T, Amuah JE, Glenn SD, Cercy K, Biryukov S, Gold AL, Chew A, Mooney MD, O'Rourke KF, Sligar A, Murray CJL, Mokdad AH, Naghavi M. Causes of death among children aged 5-14 years in the WHO European Region: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Child Adolesc Health. 2018 May;2(5):321-337. doi: 10.1016/S2352-4642(18)30095-6. PMID: 29732397; PMCID: PMC5928398.

2. Ministerio de Salud. Departamento de Epidemiología. “Plan Nacional de Cáncer Infantoadolescente 2023-2028”. 2023

3. Ministerio de Salud. Departamento de Epidemiología. Tercer Informe de Vigilancia de Cáncer Infantil. Registro Nacional de Cáncer Infantil RENCI. Trienio 2017-2019. 2023

4. Martínez S, Rueda E. Eventos adversos y complicaciones del tratamiento antineoplásico administrados durante la infancia. MÉD.UIS.2014; 27(3):77-88.

5. Fernández-Plaza S, Reques Llorente B. Tratamiento del cáncer en pediatría: principios de la terapia multimodal. Pediatr Integral. 2012; XVI(7): 540-551.

6. Effinger KE, Migliorati CA, Hudson MM, McMullen KP, Kaste SC, Ruble K, Guilcher GM, Shah AJ, Castellino SM. Oral and dental late effects in survivors of childhood cancer: a Children's Oncology Group report. Support Care Cancer. 2014 Jul;22(7):2009-19. doi: 10.1007/s00520-014-2260-x. Epub 2014 Apr 30. PMID: 24781353; PMCID: PMC4118932.

7. Carrillo CM, Corrêa FN, Lopes NN, Fava M, Odone Filho V. Dental anomalies in children submitted to antineoplastic therapy. Clinics (Sao Paulo). 2014 Jun;69(6):433-7. doi: 10.6061/clinics/2014(06)11. PMID: 24964309; PMCID: PMC4050327.

8. Hölttä P, Alaluusua S, Saarinen-Pihkala UM, Peltola J, Hovi L. Agenesis and microdontia of permanent teeth as late adverse effects after stem cell transplantation in young children. Cancer. 2005 Jan 1;103(1):181-90. doi: 10.1002/cncr.20762. PMID: 15540242.

9. S. Fernández-Plaza, B. Reques Llorente. Tratamiento del cáncer en pediatría: principios de la terapia multimodal. Pediatr Integral. 2012 ; XVI(7): 540-551.

10. Muñoz Mújica, P. et al. Instrumentos validados para medir la salud bucal en los niños. Salud(i)Ciencia. 2014, 20:846-851.

11. Rivera-Ramos. La importancia del OHIP (Oral Health Impact Profile) en la Odontología.Odontol. Sanmarquina 2020; 23(1):35-42.

12. Implementación de la Iniciativa Mundial de la OMS contra el Cáncer Infantil en América Latina y el Caribe. [acceso 22 enero 2025] Disponible en: https://iris.paho.org/handle/10665.2/53921

13. Ministerio de Salud. Guía de prevención y seguimiento para sobrevivientes de cáncer infantil.2017. [acceso 22 enero 2025] Disponible en: https://www.fnh.cl/publicaciones/GUIASOBREVIVIENTESCANCERINFANTIL.pdf

14. Cáncer infantil: incidencia y mortalidad por género en el mundo 2022. [acceso 22 enero 2025] Disponible en: https://es.statista.com/estadisticas/1395511/cancer-infantil-incidencia-y-mortalidad-por-genero-en-el-mundo/

15. International agency for research on Cancer. Age-Standardized Rate (World) per 100 000, Incidence, Both sexes, age [0-19], in 2022. Cancer Today. [acceso 22 enero 2025] Disponible en: https://gco.iarc.fr/today/en/dataviz/bars?types=0_1&mode=population

16. Yılmaz HH, Yazıhan N, Tunca D, Sevinç A, Olcayto EÖ, Ozgül N, Tuncer M. Cancer trends and incidence and mortality patterns in Turkey. Jpn J Clin Oncol. 2011 Jan;41(1):10-6. doi: 10.1093/jjco/hyq075. Epub 2010 Jun 17. PMID: 20558464.

17. Nishimura S, Inada H, Sawa Y, Ishikawa H. Risk factors to cause tooth formation anomalies in chemotherapy of paediatric cancers. Eur J Cancer Care (Engl). 2013 May;22(3):353-60. doi: 10.1111/ecc.12038. Epub 2013 Jan 21. PMID: 23336315; PMCID: PMC3655612.

18. Çetiner D, Çetiner S, Uraz A, Alpaslan GH, Alpaslan C, Toygar Memikoğlu TU, Karadeniz C. Oral and dental alterations and growth disruption following chemotherapy in long-term survivors of childhood malignancies. Support Care Cancer. 2019 May;27(5):1891-1899. doi: 10.1007/s00520-018-4454-0. Epub 2018 Sep 10. PMID: 30203360.

19. Stolze J, Vlaanderen KCE, Holtbach FCED, Teepen JC, Kremer LCM, Loonen JJ, van Dulmen-den Broeder E, Heuvel-Eibrink MMVD, Pal HJHV, Versluys B, van der Heiden-van der Loo M, Louwerens M, Raber-Durlacher JE, Bresters D, Brand HS. Long-Term Effects of Childhood Cancer Treatment on Dentition and Oral Health: A Dentist Survey Study from the DCCSS LATER 2 Study. Cancers (Basel). 2021 Oct 20;13(21):5264. doi: 10.3390/cancers13215264. PMID: 34771429; PMCID: PMC8582458.

20. Pedersen LB, Clausen N, Schrøder H, Schmidt M, Poulsen S. Microdontia and hypodontia of premolars and permanent molars in childhood cancer survivors after chemotherapy. Int J Paediatr Dent. 2012 Jul;22(4):239-43. doi: 10.1111/j.1365-263X.2011.01199.x. Epub 2011 Nov 17. PMID: 22092748.

21. Boj JR, Catalá M, García-Ballesta C, Mendoza A, Planells P. Odontopediatría : la evolución del niño al adulto joven. (1a. ed.). Ripano 2011.

22. Macías-Villanueva TG, Gutiérrez-Rojo JF. Percepción de microdoncia y alteración vertical de tamaño de incisivos superiores por estudiantes de la Licenciatura de Cirujano Dentista de la Universidad Autónoma de Nayarit. Odontoestomatología. 2018;XX(32):62-67. ISSN: 0797-0374. Disponible en: https://www.redalyc.org/articulo.oa?id=479657854008

23. Epstein JB, Thariat J, Bensadoun RJ, Barasch A, Murphy BA, Kolnick L, Popplewell L, Maghami E. Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. CA Cancer J Clin. 2012 Nov-Dec;62(6):400-22. doi: 10.3322/caac.21157. Epub 2012 Sep 12. PMID: 22972543.

24. Hong CH, Napeñas JJ, Hodgson BD, Stokman MA, Mathers-Stauffer V, Elting LS, Spijkervet FK, Brennan MT; Dental Disease Section, Oral Care Study Group, Multi-national Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO). A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer. 2010 Aug;18(8):1007-21. doi: 10.1007/s00520-010-0873-2. Epub 2010 May 7. PMID: 20449756; PMCID: PMC2914291.

25. Karati D, Mahadik KR, Trivedi P, Kumar D. Alkylating Agents, the Road Less Traversed, Changing Anticancer Therapy. Anticancer Agents Med Chem. 2022;22(8):1478-1495. doi: 10.2174/1871520621666210811105344. PMID: 34382529.

26. Peters GJ. Novel developments in the use of antimetabolites. Nucleosides Nucleotides Nucleic Acids. 2014;33(4-6):358-74. doi: 10.1080/15257770.2014.894197. PMID: 24940694.

27. Owosho AA, Brady P, Wolden SL, Wexler LH, Antonescu CR, Huryn JM, Estilo CL. Long-term effect of chemotherapy-intensity-modulated radiation therapy (chemo-IMRT) on dentofacial development in head and neck rhabdomyosarcoma patients. Pediatr Hematol Oncol. 2016 Sep;33(6):383-392. doi: 10.1080/08880018.2016.1219797. Epub 2016 Sep 30. PMID: 27689858; PMCID: PMC5175398.

28. Kaste SC, Goodman P, Leisenring W, Stovall M, Hayashi RJ, Yeazel M, Beiraghi S, Hudson MM, Sklar CA, Robison LL, Baker KS. Impact of radiation and chemotherapy on risk of dental abnormalities: a report from the Childhood Cancer Survivor Study. Cancer. 2009 Dec 15;115(24):5817-27. doi: 10.1002/cncr.24670. PMID: 19834960; PMCID: PMC3754878.

29. Halperson E, Matalon V, Goldstein G, Saieg Spilberg S, Herzog K, Fux-Noy A, Shmueli A, Ram D, Moskovitz M. The prevalence of dental developmental anomalies among childhood cancer survivors according to types of anticancer treatment. Sci Rep. 2022 Mar 16;12(1):4485. doi: 10.1038/s41598-022-08266-1. PMID: 35296697; PMCID: PMC8927608.

30. Anweigi L, Allen PF, Ziada H. The use of the Oral Health Impact Profile to measure the impact of mild, moderate and severe hypodontia on oral health-related quality of life in young adults. J Oral Rehabil. 2013 Aug;40(8):603-8. doi: 10.1111/joor.12062. Epub 2013 May 21. PMID: 23691921.

31. Ramírez-Barrantes, JC. Rehabilitación estética mínimamente invasiva en diente anterior afectado por hipoplasia de esmalte: Reporte de caso clínico. Odovtos International Journal of Dental Sciences. 2019; v. 21, n. 3, p. 17-31. doi:10.15517/ijds.v0i0.36764

32. Leukemia y lymphoma Society. Dental and Oral Complications of Cancer Treatment Facts No. 29 . 2016

33. Portugal, AA, Vega MM, Centeno NE, Martínez AV. Odontopediatría en Acción Tomo 1. Ecuador: Cuevas Editores SAS. 2023. DOI: http://doi.org/10.56470/978-9942-650-11-5.

34. García VJ, Ustrell JM, Sentís J. Evaluación de la maloclusión, alteraciones funcionales y hábitos orales en una población escolar: Tarragona y Barcelona. Avances en Odontoestomatología. 2011; 27(2), 75-84. [acceso 05 de junio 2024] Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-12852011000200003&lng=es&tlng=es.

35. Khan S, Maheshwari S, Khan MT, Verma SK. Long term dento-facial effects of radiotherapy in a treated patient of retinoblastoma. J Oral Biol Craniofac Res. 2014 Sep-Dec;4(3):214-7. doi: 10.1016/j.jobcr.2014.11.001. Epub 2014 Nov 22. PMID: 25737947; PMCID: PMC4307000.

36. Bica C, Chincesan M, Esian D, Martha K, Ion V, y cols. Dental development in children after chemotherapy. Rev Chim. 2017 Jun 68(6):1397-1400. doi:10.37358/RC.17.6.5681.

37. Oğuz A, Cetiner S, Karadeniz C, Alpaslan G, Alpaslan C, Pinarli G. Long-term effects of chemotherapy on orodental structures in children with non-Hodgkin's lymphoma. Eur J Oral Sci. 2004 Feb;112(1):8-11. doi: 10.1111/j.0909-8836.2004.00094.x. PMID: 14871187.

38. Kılınç G, Bulut G, Ertuğrul F, Ören H, Demirağ B, Demiral A, Aksoylar S, Kamer ES, Ellidokuz H, Olgun N. Long-term Dental Anomalies after Pediatric Cancer Treatment in Children. Turk J Haematol. 2019 Aug 2;36(3):155-161. doi: 10.4274/tjh.galenos.2018.2018.0248. Epub 2018 Oct 16. PMID: 30322830; PMCID: PMC6682778.

39. Lauritano D, Petruzzi M. Decayed, missing and filled teeth index and dental anomalies in long-term survivors leukaemic children: a prospective controlled study. Med Oral Patol Oral Cir Bucal. 2012 Nov 1;17(6):e977-80. doi: 10.4317/medoral.17955. PMID: 22926470; PMCID: PMC3505719.

40. Rabassa-Blanco J, Brunet-Llobet L, Marcote-Sinclair P, Balsells-Mejía S, Correa-Llano MG, Miranda-Rius J. Prevalence of, and risk factors for, dental sequelae in adolescents who underwent cancer therapy during childhood. Oral Dis. 2024 Mar;30(2):604-614. doi: 10.1111/odi.14317. Epub 2022 Aug 10. PMID: 35841375.

41. Ruyssinck L, Toulouse K, Bordon Cueto de Braem V, Cauwels R, Dhooge C. Impact of Hematopoietic Stem Cell Transplantation on Dental Development. Biol Blood Marrow Transplant. 2019 Jan;25(1):107-113. doi: 10.1016/j.bbmt.2018.08.027. Epub 2018 Sep 4. PMID: 30189246.

42. Avşar A, Elli M, Darka O, Pinarli G. Long-term effects of chemotherapy on caries formation, dental development, and salivary factors in childhood cancer survivors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Dec;104(6):781-9. doi: 10.1016/j.tripleo.2007.02.029. Epub 2007 Jul 6. PMID: 17618135.

43. Cubukcu CE, Sevinir B, Ercan I. Disturbed dental development of permanent teeth in children with solid tumors and lymphomas. Pediatr Blood Cancer. 2012 Jan;58(1):80-4. doi: 10.1002/pbc.22902. Epub 2011 Jan 19. PMID: 21254371.

44. Hutton A, Bradwell M, English M, Chapple I. The oral health needs of children after treatment for a solid tumour or lymphoma. Int J Paediatr Dent. 2010 Jan;20(1):15-23. doi: 10.1111/j.1365-263X.2009.00999.x. PMID: 20059589.

45. Marec-Berard, P., Azzi, D., Chaux-Bodard, A. G., Lagrange, H., Gourmet, R., y cols. (2005). Long-term effects of chemotherapy on dental status in children treated for nephroblastoma. Pediatric hematology and oncology, 22(7), 581–588. doi:10.1080/08880010500198848.

46. Owosho AA, Brady P, Wolden SL, Wexler LH, Antonescu CR, Huryn JM, Estilo CL. Long-term effect of chemotherapy-intensity-modulated radiation therapy (chemo-IMRT) on dentofacial development in head and neck rhabdomyosarcoma patients. Pediatr Hematol Oncol. 2016 Sep;33(6):383-392. doi: 10.1080/08880018.2016.1219797. Epub 2016 Sep 30. PMID: 27689858; PMCID: PMC5175398.

47. Quispe RA, Rodrigues ACC, Buaes AMG, Capelozza ALA, Rubira CMF, Santos PSDS. A case-control study of dental abnormalities and dental maturity in childhood cancer survivors. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Nov;128(5):498-507.e3. doi: 10.1016/j.oooo.2019.07.005. Epub 2019 Jul 15. PMID: 31409543.

48. Tanaka M, Kamata T, Yanagisawa R, Morita D, Saito S, Sakashita K, Shiohara M, Kurita H, Koike K, Nakazawa Y. Increasing Risk of Disturbed Root Development in Permanent Teeth in Childhood Cancer Survivors Undergoing Cancer Treatment at Older Age. J Pediatr Hematol Oncol. 2017 Apr;39(3):e150-e154. doi: 10.1097/MPH.0000000000000788. PMID: 28234739.

49. Wilberg P, Kanellopoulos A, Ruud E, Hjermstad MJ, Fosså SD, Herlofson BB. Dental abnormalities after chemotherapy in long-term survivors of childhood acute lymphoblastic leukemia 7-40 years after diagnosis. Support Care Cancer. 2016 Apr;24(4):1497-506. doi: 10.1007/s00520-015-2940-1. Epub 2015 Sep 12. PMID: 26361760.

50. Jodłowska A, Postek-Stefańska L. Duration and dose of chemotherapy and dental development. Dent Med Probl. 2022 Jan-Mar;59(1):45-58. doi: 10.17219/dmp/138914. PMID: 35359034.