Tooth development in the light of cancer survivors’ examination*

Introduction. The mechanisms determining the final
tooth shape and size are still not well understood.
Knowing the precise time of an antineoplastic
management and analyzing the subsequent
complications resulting from the said harmful therapy
may be helpful in finding out more about dental
development. Aim of the study. To analyze the process
of tooth germ growth on the basis of examination of
patients treated with chemotherapy. Materials and
methods. A total of ten cancer survivors with tooth
agenesis and microdontia were interviewed and
underwent clinical and radiographic examinations.
Results. In all, 38 disturbed teeth were revealed: 11
missing germs (1 first premolar, 5 second premolars,
3 second molars and 2 lateral incisors) and 27
microdontic teeth (9 first and 5 second premolars, 9
second molars, 2 lateral incisors and 2 third molars).
Selected patients underwent cancer treatment between
9 months and 10 years of age. In the majority of cases
the age at diagnosis slightly preceded the average
time when the mineralization of affected teeth began.
Conclusions. Cytotoxic therapy may be responsible
for the damage to ectodermal germ cells resulting,
among others in hypodontia and microdontia. These abnormalities have been described as occurring at
the initiation and bud stage, respectively. Taking into
account that chemotherapy was most often administered
to the examined patients shortly before tooth germ
mineralization, it seems possible the anomalies might
have occurred at the later stage of tooth development