Disturbances in the dental development and cranofacial growth in children treated with haematopoetic stem cell transplantation

Dental development and craniofacial growth were studied in 46 long term survivors of haematopoietic stem cell transplantation (SCT) performed in childhood, before the age of 12 (mean age 6.9 years). The aim of the study was to investigate the correlation between age at SCT, degree of disturbances in dental development and vertical growth of the face. A panoramic and a cephalometric radiograph were taken at a mean age of 15.9 years. For each patient two age and sex matched healthy controls were included. The area of three mandibular teeth was measured and a cephalometric analysis was performed. The results show that the mean area of the mandibular central incisor, first and second molar was significantly smaller in the SCT group and that the vertical growth of the face was significantly reduced, especially in the lower third, compared to healthy controls. We also found a statistically significant correlation between age at SCT, degree of disturbances in dental development and vertical growth of the face. In conclusion: The younger the child is at SCT the greater the impairment in dental and vertical facial development. This supports the earlier suggestion that the reduction in lower facial height found in SCT children mainly is a result of impaired dental development, and that young age is a risk factor for more severe disturbances.