Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2018, vol. 55, nr 3, July-September, p. 343–349

doi: 10.17219/dmp/95028

Publication type: clinical case

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Microdontia after chemotherapy in a patient treated for neuroblastoma: Histopathological findings

Mikrodoncja po chemioterapii u pacjenta leczonego z powodu nerwiaka zarodkowego – badania histopatologiczne

Anna Jodłowska1,A,B,C,D, Jacek Pająk2,B,C,E, Lidia Postek-Stefańska1,E,F

1 Department of Pediatric Dentistry, Medical University of Silesia, Katowice, Poland

2 Department of Patomorphology and Molecular Diagnostics, Medical University of Silesia, Katowice, Poland


Microdontia is one of the late effects of antineoplastic therapy in children. This study is based on the comparative histological examination of abnormal, peg-shaped premolars, erupted in a patient treated for neuroblastoma, and of non-affected teeth, extracted in a healthy child. Apart from the size, the teeth vary in tissue morphology. The number of dentinal tubules, dependent on the number of odontoblasts, is smaller in the microdontal sample when observation in the same-sized field of view is conducted. Moreover, the youngest, more than 100-micrometer-thick layer of the microdontal dentin seems to be the secondary dentin, with crispy-shaped tubules and empty spaces between them. No irregular dentin is deposited in the samples of physiologically developed teeth. The structure of cementum is different as well. Unlike regularly shaped premolars, in which typical 2-layer tissue is seen, in sections of microdontal teeth, only acellular tissue with cementoblasts overlying its surface is present. Thorough analysis of drug administration effects, which are visible in microscopic sections, and of time of anticancer treatment could provide insight into the developmental mechanisms of tooth germ formation.

Key words

chemotherapy, histopathology, tooth abnormalities, neuroblastoma

Słowa kluczowe

chemioterapia, histopatologia, zaburzenia zębowe, nerwiak zarodkowy

References (30)

  1. Avşar A, Darka O, Pinarli G. Long-term effects of chemotherapy on caries formation, dental development and salivary factors in childhood cancer survivors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(3):781–789.
  2. Marec-Berard P, Chaux-Bodard AG, Lagrange H, Azzi D, Gourmet R, Bergeron C. Long-term effects of chemotherapy on dental status in children treated for nephroblastoma. Pediatr Hematol Oncol. 2005;22(7):581–588.
  3. Hölttä P, Alaluusua S, Saarinen-Pihkala UM, Peltola J, Hovi L. Agenesis and microdontia of permanent teeth as late adverse effects after stem cell transplantation in young children. Cancer. 2005;103(1):181–190.
  4. Minicucci EM, Lopes LF, Crocci AJ. Dental abnormalities in children after chemotherapy treatment for acute lymphoid leukemia. Leuk Res. 2003;27(1):45–50.
  5. Hölttä P, Alaluusua S, Saarinen-Pihkala UM, Wolf J, Nyström M, Hovi L. Long-term adverse effects on dentition in children with high-dose chemotherapy and autologous stem cell transplantation with or without total body irradiation. Bone Marrow Transplant. 2002;29(2):121–127.
  6. Kaste SC, Hopkins KP, Jenkins JJ. Abnormal odontogenesis in children treated with radiation and chemotherapy: Imaging findings. AJR Am J Roentgenol. 1994;162(6):1407–1411.
  7. Pajari U, Lanning M, Larmas M. Prevalence and location of enamel opacities in children after anti-neoplastic therapy. Community Dent Oral Epidemiol. 1988;16(4):222–226.
  8. Dahllöf G, Rozell B, Forsberg CM, Borgström B. Histologic changes in dental morphology induced by high-dose chemotherapy and total body irradiation. Oral Surg Oral Med Oral Pathol. 1994;77(1):56–60.
  9. Remmers D, Bökkerink JPM, Katsaros C. Microdontia after chemotherapy in a child treated for neuroblastoma. Orthod Craniofac Res. 2006;9(4):206–210.
  10. Kaste SC, Hopkins KP, Bowman LC, et al. Dental abnormalities in children treated for neuroblastoma. Med Pediatr Oncol. 1998;30(1):22–27.
  11. Näsman M, Forsberg CM, Dahllöf G. Long-term dental development in children after treatment for malignant disease. Eur J Orthod. 1997;19(2):151–159.
  12. Stene T, Koppang HS. Autoradiographic investigation of proliferative responses in rat incisor pulp after vincristine administration. Scand J Dent Res. 1980;88(2):96–103.
  13. Stene T. Vincristine’s effect on dentinogenesis in rat incisor. Scand J Dent Res. 1979;87(1):39–49.
  14. Stene T. Effect of vincristine on odontoblasts in rat incisors. Scand J Dent Res. 1978;86(5):346–356.
  15. Lyaruu DM, van Duin MA, Bervoets TJM, Wöltgens JH, Bronckers AL. Effects of actinomycin D on developing hamster molar tooth germs in vitro. Eur J Oral Sci. 1997;105(1):52–58.
  16. de Oliveira Nogueira T, Stene T, Koppang HS. Long-terms effects of colchicine on dentinogenesis in rat incisors. Scand J Dent Res. 1980;88(1):15–21.
  17. Dahl JE. Influence of doxorubicin on rat incisor mesenchymal cells. Scand J Dent Res. 1984;92(1):6–13.
  18. Goho C. Chemoradiation therapy: Effect on dental development. Pediatr Dent. 1993;15(1):6–12.
  19. Takuma S, Sawada T, Yama S, Yanagisawa T. Ultrastructural changes in the cementoblasts of rat molars after injection of vincristine. J Dent Res. 1984;63(9):1108–1115.
  20. Takuma S, Sawada T, Yanagisawa T. Ultrastructural changes of secreting rat-incisor ameloblasts following administration of vincristine and vinblastine. J Dent Res. 1982;61(Spec No):1472–1478.
  21. Jodłowska A, Postek-Stefańska L, Pietraszewska D, et al. Tooth development in the light of cancer survivors’ examination. J Stoma. 2016;69:659–666.
  22. Olley RC, Xavier GM, Seppala M, et al. Expression analysis of candidate genes regulating successional tooth formation in the human embryo. Front Physiol. 2014;5:445.
  23. Macleod RI, Welbury RR, Soames JV. Effects of cytotoxic chemotherapy on dental development. J R Soc Med. 1987;80(4):207–209.
  24. Maguire A, Craft AW, Evans RGB, et al. The long-term effects of treatment on the dental condition of children surviving malignant disease. Cancer. 1987;60(10):2570–2575.
  25. Bath-Balogh M, Fehrenbach MJ. Illustrated Dental Embryology, Histology, and Anatomy. Philadelphia, PA: W.B. Saunders Company; 1997:65.
  26. Fehrenbach MJ. Review of tooth development and associated developmental disturbances. J Pract Hyg. 2000;5–6:12–14.
  27. Kumar GS. Orban’s Oral Histology and Embryology. 13th ed. Gurgaon, India: Elsevier India; 2011:27–38.
  28. Nanci A. Ten Cate’s Oral Histology. Development, Structure and Function. 8th ed. St. Louis, MO: Mosby; 2012:70–89.
  29. Cameron AC, Widmer RP. Handbook of Pediatric Dentistry. 3rd ed. St. Louis, MO: Mosby Elsevier; 2008:458–459.
  30. Rosenberg SW, Kolodney H, Wong GY, Murphy ML. Altered dental root development in long-term survivors of pediatric acute lymphoblastic leukemia. Cancer. 1987;59(9):1640–1648.