Pictorial review of Developing Dentition in children treated with BMT

Objective: The purpose of the study is to provide a pictorial representation of dental anomalies in children who have undergone bone marrow transplantation (BMT) to treat Acute Lymphocytic Leukemia (ALL). Modern treatments such as BMT have greatly increased the survival rates of children diagnosed with ALL, but these treatments have also shown deleterious effects on the development of the dentition. Methods: A retrospective study of medical records and panoramic radiographs of ALL patients who underwent BMT at St. Jude Children's Research Hospital between 1990 and 2008, for whom both pre-BMT and post-BMT panoramic radiographs were available, was performed. 79 patients (29 female, 50 male) were identified as fitting the criteria of having the necessary radiographs available for study. Each individual radiograph for a given patient, ranging in number from 1 to 9, was assessed for the presence of several developmental abnormalities, including, delayed eruption, primary over retention, enamel pearls, hypodontia, microdontia, pulp stones and root stunting. Results: No statistical inferences were made based on the nature of the data, and only descriptional statistics were completed. Of the 79 patients, 47 were Caucasian, 12 African-American, 8 Hispanic, and 12 were of other races. 43 patients were found to have one or more anomalies, 36 patients were normal, having no anomalies. Patients for the pictorial essay were selected as model examples of the possible deleterious effects on the development of the dentition, following BMT. Conclusion: The Pictorial essay will allow healthcare providers to not only explain possible adverse effects of BMT on the dentition, but also visually be able to show the outcomes of patients treated with BMT.