Different Dental Developments Following Chemotherapy in Two Neuroblastoma Cases

Abstract

We present the results of two patients treated with both chemotherapy and surgery for neuroblastoma at an early age (stage III). Stage, age, MYCN oncogene status, and histologic category are prognostic factors in such cases. Those factors have been incorporated into risk-group classification based on the results of a risk-based clinical trial. Our first patient was diagnosed with a neuroblastoma at the age of 1 year 8 months. MYCN amplification was indicated, thus the case was classified as high risk. We used a 5-course chemotherapy regimen and autologous stem cell transplantation for a period of 6 months from the age of 1 year 10 months to 2 years 4 months. Dental abnormalities included short roots and arrested root development of the primary second molars, and permanent first molars and incisors, as well as microdontia of the first premolars and aplasia of the upper left permanent second molar. The second patient was diagnosed with a neuroblastoma at 10 months old. MYCN amplification was not indicated and the case was classified as intermediate risk. The neuroblastoma was treated with 5 courses of chemotherapy for 4 months from 10 months to 1 year 1 month old. This patient did not have any dental abnormalities. The chemotherapy regimen in the first case was more intensive as compared to the second. Disturbances in dental development in the first case compromised malocclusion, open bite, and crossbite. Orthodontic treatment for patients with severely disturbed root development should be given with light forces.