Use of new targeted cancer therapies in children: effects on dental development and risk of jaw osteonecrosis: a review |
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Authors: | Magali Hernandez Bérengère Phulpin Ludovic Mansuy Dominique Droz |
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Institution: | 1. Pediatric Dentistry Department, CHRU of Nancy, Vandoeuvre‐les‐Nancy, France;2. Pediatric Dentistry Department, Faculty of Dentistry, Nancy, France;3. Head and Neck Surgery and Dental Units, Oncology Surgery Department, Institute of Cancerology of Lorraine, Vandoeuvre‐lès‐Nancy, France;4. Oral Surgery Department, Faculty of Dentistry, Nancy, France;5. Pediatric Oncology Department, CHRU of Nancy, Vandoeuvre‐les‐Nancy, France |
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Abstract: | New targeted cancer therapies such as bisphosphonates, denosumab, and bevacizumab are routinely used in adult for the past decades. Their introduction into pediatric medicine is more recent that means there is a paucity of data on long‐term effects on dental development and on the risk of osteonecrosis of jaw. This study aimed to outline adverse effects of new targeted cancer therapies on oral cavity including dental abnormalities observed in pediatric population treated with these molecules and the risk of osteonecrosis of the jaw (ONJ). The impact of bisphosphonates and denosumab on bone remodeling (inhibition of osteoclasts) could interfere with teeth exfoliation and eruption processes, causing a tooth eruption delay. This hypothesis was confirmed, bisphosphonate‐treated rats presented tooth eruption delay, and bisphosphonate therapy was associated with a mean delay of 1.67 years in tooth eruption in children with osteogenesis imperfecta. Another study showed that the inhibition of RANK/RANKL by denosumab was associated with a lack of tooth eruption in animals. Several animal studies reported that bisphosphonate could also induce dental abnormalities including defective amelogenesis and dentinogenesis in rats, but there is no evidence of such effects in children; only one case of enamel hypoplasia in a child treated for idiopathic arterial calcification with bisphosphate was reported. To date, there has been no reported case of ONJ in children treated with bisphosphonates, denosumab, or bevacizumab. |
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Keywords: | bevacizumab bisphosphonates buccal effects children denosumab |
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