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Long-Term Outcomes of Periodontal Interventions in Children with Leukemia: A Retrospective Analysis
Anuj Singh Parihar1, Bhawna Gupta2, Parth Shailesh Bhatt3
1Department of Periodontology, People's Dental Academy, Bhopal, Madhya Pradesh, India.
Background:
Leukemia and its treatment compromise oral health, increasing periodontal disease risk in children. This study evaluated the long-term effects of periodontal interventions in children with leukemia.
Methods:
We reviewed records of 85 children with leukemia receiving periodontal treatment at People's Dental Academy (2010-2020). Data included demographics, leukemia subtype (Acute Lymphoblastic Leukemia [ALL], Acute Myeloid Leukemia [AML], others), chemotherapy, Hematopoietic Stem Cell Transplantation [HSCT] history, periodontal diagnosis (gingivitis, periodontitis), interventions (scaling/root planing, surgery), and clinical parameters (Pocket Depth [PD], Clinical Attachment Level [CAL], Bleeding on Probing [BOP], radiographic bone loss) at baseline, one, three, and five years. Patients with ≥ three-year follow-up were included. Data were analyzed using descriptive statistics and repeated measures analysis of variance (ANOVA).
Results:
The cohort comprised 45 ALL, 30 AML, and 10 other leukemia subtypes. At baseline, 70% had gingivitis, 30% periodontitis. Scaling/root planing was most common. At one year, PD (3.2 mm to 2.5 mm, P < 0.001) and BOP (60% to 25%, P < 0.001) significantly decreased. Improvements were maintained at three years (PD 2.2 mm, P < 0.01 vs 1 year) and five years. HSCT patients showed similar improvements. No significant differences existed between leukemia subtypes. One patient experienced minor gingival recession post-surgery.
Conclusions:
Even after chemotherapy or HSCT, periodontal interventions sustain long-term periodontal health in children with leukemia. The importance of maintaining, as well as comprehensive oral health care and periodontal therapy stares at us from the five-year follow-up data. These results also illustrate the scant literature available on the long-term periodontal effects on these patients, pertaining to integrated dental practices. Further longitudinal research is warranted to confirm these results and identify additional risk factors.
