Antineoplastic therapy is an independent risk factor for dental caries in childhood cancer patients: a retrospective cohort study.

PURPOSE: To evaluate the antineoplastic therapy (AT) as a risk factor for dental caries lesions independent of other risk factors such as income, family education, stimulated salivary flow rate, hygiene habits, frequency of sugar intake, and microbiota in childhood cancer (CC) patients. METHODS: 72 individuals were divided into CC patients (n=36) and healthy individuals (control group - CT n=36). Demographic data, hygiene habits, frequency of sugar intake, CC type, and AT were collected. Stimulated salivary flow rate was measured and the presence and concentration of Streptococcus mutans were assessed using a real-time polymerase chain reaction (qPCR) technique. Clinical evaluations included plaque index (PI) and decayed-missing-filled-teeth index (dmft/DMFT). Descriptive statistics, T-test, Mann-Whitney test, chi-square test, Fisher's exact test, and two-way analysis of variance were used for data analysis (p<0.05). RESULTS: At the time of oral evaluation, both groups exhibited similar ages with means of 12.0±3.9 years old for CC and 12.0±4.0 years old for CT patients. All CC patients underwent chemotherapy with nine also undergoing radiotherapy. Significant differences were observed between the groups in terms of color/race, income, family education, and hygiene habits. However, no statistically significant differences were found between groups regarding the frequency of sugar intake, stimulated salivary flow rate, or the concentration of Streptococcus mutans (qPCR technique). For clinical parameters, the DMF (CC:1.80, CT: 0.75), decayed (CC: 0.88, CT: 0.19), missing (CC: 0.25, CT:0), and PI (CC: 30.5%, CT: 22.6%) were higher in the CC group (p<0.05). CONCLUSION: Childhood cancer (CC) patients undergoing antineoplastic therapy (AT) exhibit a higher prevalence of dental caries, regardless of income/education, frequency of sugar intake, stimulated salivary flow rate, and microbiota.

Surgical-orthodontic therapy of compound odontoma in the anterior maxilla / Tratamento cirúrgico e ortodôntico de odontoma complexo em região anterior de maxila

abstract Odontomas are odontogenic tumors subdivided into complex type (common in the posterior mandible region) and compound type. These lesions are usually asymptomatic and diagnosed in routine examinations, are more frequent in the second decade of life. The objective of this case is to report the treatment of a patient with complex odontoma in childhood in the anterior maxilla. A nine-year-old patient sought dental care due to non-eruption of an anterior permanent tooth. After clinical examination and radiographic analysis, the diagnostic hypothesis of odontoma was confirmed. Surgical removal of the lesion and use of orthodontic appliances were indicated. After the therapeutic protocol, the case was completely resolved. Due to the absence of symptoms, many cases of odontomas are neglected. However, it is evident that the sooner diagnosed, the better the prognosis of the patient.

resumen Los odontomas son tumores odontogénicos subdivididos en tipo complejo (común en región posterior de mandíbula) y tipo compuesto. Esas lesiones generalmente son asintomáticas y diagnosticadas en pruebas de rutina; son más frecuentes en la segunda década de vida. El objetivo de este caso es el de reportar el tratamiento de un paciente con odontoma complejo de la infancia en región anterior de maxilar. Niño de 9 años acudió a la clínica odontológica a causa de la no erupción de un diente permanente anterior. Tras examen clínico y análisis radiográfico, se estableció la hipótesis diagnóstica de odontoma. Remoción quirúrgica de la lesión y uso de aparato dental fueron indicados. Después del protocolo terapéutico se hizo la resolución completa del caso. Debido a la ausencia de síntomas, muchos casos de odontomas son ignorados. Sin embargo, cuanto antes sea diagnosticado, mejor será el pronóstico del paciente.

resumo Odontomas são tumores odontogênicos subdivididos em tipo complexo (comum em região posterior de mandíbula) e tipo composto. Essas lesões geralmente são assintomáticas e diagnosticadas em exames de rotina; são mais frequentes na segunda década de vida. O objetivo deste caso é relatar o tratamento de um paciente com odontoma complexo na infância em região anterior de maxila. Paciente de 9 anos procurou a clínica odontológica devido a não erupção de um dente permanente anterior. Após exame clínico e análise radiográfica, a hipótese diagnóstica de odontoma foi confirmada. Remoção cirúrgica da lesão e uso de aparelho ortodôntico foram indicados. Após o protocolo terapêutico foi realizada resolução completa do caso. Devido à ausência de sintomas, muitos casos de odontomas são negligenciados. Entretanto, quanto antes diagnosticado, melhor será o prognóstico do paciente.