Temporomandibular Joint and Dental Complications in Long-Term Survivors of Children with Leukemia after Chemoradiotherapy and Stem Cell Transplantation

IF 0.9 4区医学

Indian Journal of Hematology and Blood Transfusion Pub Date : 2024-04-29 DOI:10.1007/s12288-024-01786-y

Öykü Öztürk Gündoğdu, Dilek Aynur Cankal, Zühre Kaya, Zühre Akarslan, Serap Kirkiz, Ülker Koçak

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Abstract

The purpose of this study was to investigate the long-term effects of chemoradiotherapy and transplantation on the temporomandibular joint (TMJ) and dental status in leukemia and stem cell transplantation (SCT) patients. The study included 44 patients and 22 controls. Participants were categorized into three groups: patients with leukemia in Group-1 (n = 22), patients with SCT in Group-2 (n = 22), and controls in Group-3 (n = 22). All patients were evaluated using the Diagnostic Criteria for TMJ Disorders (TMD), as well as clinical and radiographic assessments. TMD was found in 19 (86%) of the 22 patients in Group-1, 12 (54%) of the 22 patients in Group-2, and 4 (18%) of the 22 controls. The brushing habit was significantly lower in Group-2 than in other Groups (p < 0.05). Group-3 had significantly higher mean values for painless, maximum assisted, and unassisted mouth opening than the other Groups (p < 0.05). The rate of click and crepitation sounds was significantly higher in Group-1 and Group-2 than in Group-3 (p < 0.05). The rate of nondental pain was significantly higher in Group-1 than in other Groups (p < 0.05). The rate of disc displacement with a reduction in both TMJ was significantly higher in Group-1 than in Group-3 (p < 0.05). Radiological studies revealed flattening in at least one condyle in 9 (20%) of both Group-1 and Group-2 patients. Flattening of both condyles and thinning of the mandibular cortex due to osteoporosis were found in 2 (9%) of Group-2. Our data suggest that screening for TMD after chemoradiotherapy and SCT may be beneficial for pediatric leukemia.

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化疗和干细胞移植后长期存活的白血病患儿的颞下颌关节和牙齿并发症

本研究旨在调查化放疗和移植对白血病和干细胞移植（SCT）患者的颞下颌关节（TMJ）和牙齿状况的长期影响。研究包括 44 名患者和 22 名对照组。参与者分为三组：白血病患者为第一组（22 人），干细胞移植患者为第二组（22 人），对照组为第三组（22 人）。所有患者均接受了颞下颌关节紊乱症（TMD）诊断标准以及临床和放射学评估。第一组的 22 名患者中有 19 人（86%）、第二组的 22 名患者中有 12 人（54%）、对照组的 22 人中有 4 人（18%）被发现患有 TMD。第 2 组患者的刷牙习惯明显低于其他组别（p < 0.05）。第 3 组患者的无痛张口、最大辅助张口和无辅助张口的平均值明显高于其他组（p < 0.05）。第 1 组和第 2 组的咔嗒声和咯吱声发生率明显高于第 3 组（p < 0.05）。第 1 组的非牙痛率明显高于其他组（p < 0.05）。第 1 组颞下颌关节盘移位并缩小的比例明显高于第 3 组（p < 0.05）。放射学研究显示，在第一组和第二组患者中，有 9 人（20%）至少有一个髁突变平。第 2 组有 2 人（9%）因骨质疏松症导致双侧髁突变平，下颌骨皮质变薄。我们的数据表明，在化疗和 SCT 后进行 TMD 筛查可能对儿童白血病患者有益。

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Indian Journal of Hematology and Blood Transfusion Medicine-Hematology

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期刊介绍： Indian Journal of Hematology and Blood Transfusion is a medium for propagating and exchanging ideas within the medical community. It publishes peer-reviewed articles on a variety of aspects of clinical hematology, laboratory hematology and hemato-oncology. The journal exists to encourage scientific investigation in the study of blood in health and in disease; to promote and foster the exchange and diffusion of knowledge relating to blood and blood-forming tissues; and to provide a forum for discussion of hematological subjects on a national scale. The Journal is the official publication of The Indian Society of Hematology & Blood Transfusion.