DOI QR코드

DOI QR Code

DENTAL COMPLICATIONS AND MANAGEMENT OF A PATIENT WITH NEUROBLASTOMA : SPLINT OF MANDIBULAR INCISORS WITH ROOT ANOMALIES USING MINI-SCREW

신경모세포종의 의학적 치료에 따른 치과적 합병증과 관리 : Mini-screw를 이용한 치근이형성 하악 절치의 고정술

  • Cheon, Min-kyoung (School of Dentistry, Chonnam National University, Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Kim, Jae-hwan (School of Dentistry, Chonnam National University, Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Choi, Nam-ki (School of Dentistry, Chonnam National University, Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Kim, Seon-mi (School of Dentistry, Chonnam National University, Department of Pediatric Dentistry, School of Dentistry, Chonnam National University)
  • 천민경 (전남대학교 치의학대학원, 전남대학교 치의학대학원 소아치과학교실) ;
  • 김재환 (전남대학교 치의학대학원, 전남대학교 치의학대학원 소아치과학교실) ;
  • 최남기 (전남대학교 치의학대학원, 전남대학교 치의학대학원 소아치과학교실) ;
  • 김선미 (전남대학교 치의학대학원, 전남대학교 치의학대학원 소아치과학교실)
  • Received : 2015.06.21
  • Accepted : 2015.06.25
  • Published : 2015.06.30

Abstract

Neuroblastoma is a common malignant tumor of the sympathetic nervous system in childhood, arises from embryonic neural crest cells. The period of tooth development is matched with peak times of diagnosis and treatment of neuroblastoma. The intensive multimodality treatment including radiotherapy and chemotherapy is used in patients with neuroblastoma has been shown to have late adverse effects and disturbances in dental development like tooth agenesis, microdontia, enamel hypoplasia and short roots. A 8-year old girl had been on medication and radiotherapy for neuroblastoma since she was 15 months old at Department Pediatrics, Chonnam National University Hospital. Oligodontia, microdontia, and short root formation was notable in clinical and radiological examination. Mobility of lower permanent incisor was detected and measured at about degree 2. Resin wire splint using mini-screw implantation on buccal alveolar bone was conducted for maintenance of mandibular incisors and alveolar bone. Excessive mobility has been eliminated and maintained well so far. Further treatment is planned for re-evaluation of mobility, preventing dental caries and regular oral hygiene management. Although we need further evaluation, this treatment could be one of alternative therapy for those who have similar dental anomalies.

다발성 우식증을 주소로 내원한 7세 1개월의 여자아이가 신경모세포종의 다각적 치료에 따른 치근 형성이상으로 인해 하악 영구절치의 중증도 동요도를 보여 mini-screw를 이용한 레진강선고정을 시행하였다. 이를 통해 동요도의 감소 및 교합안정을 이루었으며, 따라서 하악 영구절치의 치근 형성이상으로 인한 동요도 증가 시 선택적 치료법이 될 수 있을 것이라 생각한다.

Keywords

References

  1. Gurney JG, Ross JA, Wall DA, et al. : Infant cancer in the U.S.: histology-specific incidence and trends, 1973 to 1992. J Pediatr Hematol Oncol, 19:428-432, 1997. https://doi.org/10.1097/00043426-199709000-00004
  2. Kushner BH : Neuroblastoma: a disease requiring a multitude of imaging studies. J Nucl Med, 45:1172-1188, 2004.
  3. Schour I, Massler M : Studies In Tooth Development: The Growth Pattern Of Human Teeth Part II. J Am Dent Asso, 27:1918-1931, 1940. https://doi.org/10.14219/jada.archive.1940.0367
  4. Holtta P, Alaluusua S, Saarinen-Pihkala UM : Agenesis and microdontia of permanent teeth as late adverse effects after stem cell transplantation in young children. Cancer, 103:181-190, 2005. https://doi.org/10.1002/cncr.20762
  5. Remmers D, Bokkerink JP, Katsaros C : Microdontia after chemotherapy in a child treated for neuroblastoma. Orthod Craniofac Res, 9:206-210, 2006. https://doi.org/10.1111/j.1601-6343.2006.00374.x
  6. Kaste SC, Hopkins KP, Bowman LC : Dental abnormalities in children treated for neuroblastoma. Med Pediatr Oncol, 30:22-7, 1998. https://doi.org/10.1002/(SICI)1096-911X(199801)30:1<22::AID-MPO8>3.0.CO;2-2
  7. Park JR, Angelika E, Huib C : Neuroblastoma: biology, prognosis, and treatment. Hematol Oncol Clin North Am, 24:65-86, 2010. https://doi.org/10.1016/j.hoc.2009.11.011
  8. Carano A, Velo S, Leone P : Clinical applications of the Miniscrew Anchorage System. J Clin Orthod, 39:9-24, 2005.
  9. Park YC, Kim CK, Lee JS : Atlas of Contemporary Orthodontics, Vol. III. Shinheung International, Seoul, 46-47, 2005.
  10. Holtta P, Hovi L, Saarinen-Pihkala UM : Disturbed root development of permanent teeth after pediatric stem cell transplantation. Dental root development after SCT. Cancer, 103:1484-1493, 2005. https://doi.org/10.1002/cncr.20967
  11. Holtta P, Alaluusua S, Saarinen-Pihkala UM : Long-term adverse effects on dentition in children with poor-risk neuroblastoma treated with high-dose chemotherapy and autologous stem cell transplantation with or without total body irradiation. Bone Marrow Transplant, 29:121-127, 2002. https://doi.org/10.1038/sj.bmt.1703330
  12. Pajari U, Ollila P, Lanning M : Incidence of dental caries in children with acute lymphoblastic leukemia is related to the therapy used. ASDC J Dent Child, 62:349-352, 1994.
  13. Goho C : Chemoradiation therapy: effect on dental development. Pediatr Dent, 15:6-12, 1992.
  14. Brodeur GM, Maris JM : Principles and practice of pediatric oncology. Lippincott Williams & Williams, Philadelphia, 895-937, 2002.