Oral and dental alterations and growth disruption following chemotherapy in long-term survivors of childhood malignancies.

PURPOSE: More attention has been focused on the long-term side effects of treatment protocols since impressive advances in childhood cancer treatment have resulted in a growing population of patients. The purpose of this study was to investigate the disturbances of dento-facial development in children who were long-term survivors of childhood malignancies. METHODS: Fifty-three children (mean age, 10 years + 4 months) in long-term remission underwent oral/dental and radiographic examinations after completion of therapy. Crown and root malformations, gingival/periodontal status, enamel defects, discolorations, decayed and unerupted teeth, premature apexifications, agenesis, maximal interincisal opening and lateral movement of jaws, and soft tissue abnormalities were noted. Caries were evaluated by the decayed-missing-filled teeth (DMFT) index. Forty healthy children (mean age, 12 years + 4 months) belonging to the same age group and socioeconomic community were served as controls. All participants in the study were evaluated in terms of craniofacial development. RESULTS: The data of the study showed that higher prevalence of root malformation, unerupted teeth, and enamel hypoplasia were detected as a consequence of childhood cancer and/or antineoplastic therapy. Although no differences of craniofacial growth and development were observed between groups (P > 0.05), plaque and gingival index scores were statistically higher in the study group (P < 0.05). CONCLUSION: A range of variations in dental structures is recognized as a side effect of childhood cancer therapy in long-term survivors of pediatric malignancies that may affect their quality of life.

Comparison of cephalometric measurements with digital versus conventional cephalometric analysis.

The aim of this study was to evaluate the accuracy and reliability of angular and linear cephalometric measurements using a computerized method of direct digital radiographs. This was then compared with the measurements obtained with a computerized method that uses a digitizing pad and hand tracing of printout radiographs. Pre-treatment digital cephalometric radiographs of 125 patients were traced using Vistadent 2.1 AT and Jiffy Orthodontic Evaluation (JOE) software programs and by hand tracing of the printouts. Twenty-six anatomical landmarks were defined on each radiograph by a single investigator and 28 variables were calculated. Statistical analysis was undertaken using one-way analysis of variance and multiple group comparisons using Duncan's test at a significance level of 0.05. Low correlation coefficients indicated poor reproducibility for nasolabial angle for each of the three methods (P > 0.05). Most of the variables showed consistency between the three methods except for nasolabial angle, ANS-Me, APFH, L1-NB, Nperp-Pg, Go-Me, and U1-NA measurements. The findings indicated that most of the cephalometric measurements were highly reproducible with direct digital radiographs using Vistadent 2.1 AT as well as with printouts using both JOE software and hand tracing. Despite the low correlation for some measurements between the Vistadent 2.1 AT, JOE, and hand-tracing methods, most of the commonly used measurements were accurate. The user-friendly and time-saving nature of the computerized method using digital radiographs makes it the preferred option.

Differences in cephalometric measurements: a comparison of digital versus hand-tracing methods.

The aim of this study was to evaluate the accuracy of cephalometric measurements using computerized tracing of direct digital radiographs in comparison with hand tracing of digital radiographic printouts. Comparisons were made between methods in terms of accuracy of individual measurements as well as evaluation of treatment outcomes. Pre- (T1) and post- (T2) treatment cephalometric digital radiographs of 30 patients were traced using the Vistadent OC 1.1 computer software program (group 1) and manually (group 2) by the same investigator. A total of 26 anatomical landmarks were located and measured. Measurement reproducibility was evaluated by calculating intraclass correlation coefficients, and paired t-tests were used to compare differences in individual measurements and treatment outcomes between methods. Differences greater than 0.05 were considered to be statistically significant. Significant differences were found between the two methods for SNB, Wits appraisal, Cd-A, Cd-Gn, FMA, SN-PP, U1-NA (mm), U1-FH, L1-NB (mm), and Li-E plane. No significant differences were found between the two methods in the measurement of treatment changes. Cephalometric measurements of most parameters were reproducible for both methods. Despite some discrepancies in measured values between hand-tracing and the computerized method, any differences were minimal and clinically acceptable.

Three-dimensional tooth crown size symmetry in cleft lip and cleft palate.

OBJECTIVE: To evaluate and compare three-dimensional tooth size symmetry in the right and left sides of upper and lower dental arches in cleft lip and palate (CLP) patients and to compare it with an Angle Class I normal occlusion control group. MATERIALS AND METHODS: Dental casts of 72 individuals with CLP (20 bilateral [BCLP], 34 unilateral left [ULCLP], and 18 unilateral right [URCLP]) and 53 individuals with Class I occlusion, all with permanent dentition, were randomly selected. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements of upper and lower teeth were recorded with a digital caliper. Descriptive statistics and paired t-test were used for statistical analysis. RESULTS: Significant asymmetries were found between the right and left sides of the dental arches in CLP as follows: MD dimension: mandibular first premolar (ULCLP, P < .01); LL dimension: mandibular first premolar (URCLP, P < .05); OG dimension: maxillary central incisor and first premolar (ULCLP, P < .05 and P < .01, respectively), central incisor (BLCLP, P < .01), mandibular canine and first premolar (ULCLP, P < .01), and first molar (ULCLP, P < .05). Tooth crown size asymmetries were also recorded in the Class I group. CONCLUSIONS: Significant three-dimensional tooth size asymmetries were found in CLP subjects; however, such asymmetries were also present on the Class I control group.