Root surface areas in long-term survivors of childhood cancer

Treatment regimes for childhood cancer are known to affect the root development in the long-term survivors (LTS) but the available the data is subjective in nature with very few quantitative data in the literature. This study aimed to quantify the root surface area (RSA) of mandibular teeth in LTS compared with controls and relate this to the treatment regime and also to the age at which the cancer was diagnosed. Panoramic radiographs were obtained from 69 LTS and an equal number of appropriately matched healthy controls. RSA were calculated using Computer Linked Image Analysis. RSA in the LTS were found to be significantly smaller as compared with controls. Also, RSA were the least in those LTS who had Total Body Irradiation followed by Bone Marrow Transplantation (TBI/BMT) compared with other treatment regimes, the difference being statistically significant for all teeth studied. There was no relationship between the RSA and the age at which the cancer was diagnosed. Smaller root areas have implications for the oral health of LTS, as bone loss around such teeth will compromise further their periodontal support thus jeopardising the long-term survival of the tooth.