nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.21682/2311-1267-2021-8-3-86-96nodgo-747Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSСтоматологические нарушения у пациентов, излеченных от злокачественного новообразования в детском возрастеDental disorders in patients recovered from malignant neoplasms in childhoodСмирновД. Ф.SmirnovD. F.

к.м.н., врач-хирург-стоматолог высшей квалификационной категории HighGuard Clinic

AuthorID: 53467 

107045, Москва, Рыбников пер., 1

Cand. of Sci. (Med.), Dental Surgeon of the Highest Qualification Category 

AuthorID: 53467 

1 Rybnikov Per., Moscow, 107045

dfsmirnov2007@yandex.ruСидоренкоЛ. В.SidorenkoL. V.

Людмила Васильевна Сидоренко,  к.м.н., врач-детский онколог высшей квалификационной категории, ведущий научный сотрудник отдела педиатрии; привлеченный сотрудник отдела организации научной деятельности подведомственных учреждений, осуществляющих научные исследования и разработки

Author ID: 697440 

117997, Москва, ул. Саморы Машела, 1

107045, Москва, Колокольников пер., 21

Cand. of Sci. (Med.), Pediatric Oncologist of the Highest Qualification Category, Leading Researcher of the Department of Pediatrics; Engaged Employee of the Department for Organizing Scientific Activities of Subordinate Institutions Carrying out Research and Development

Author ID: 697440 

1 Samory Mashela St., Moscow, 117997

21 Kolokolnikov Per., Moscow, 107045

SidorenkoLV@rosminzdrav.ruКлинико-диагностический центр High Guard ClinicРоссияClinical and Diagnostic Center High Guard ClinicRussian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева» Минздрава России; Департамент науки и инновационного развития здравоохранения Министерства здравоохранения Российской ФедерацииРоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia; Department of Science and Innovative Development of Health Care of the Ministry of Health of the RussiaRussian Federation202118102021838696Copyright © Смирнов Д.Ф., Сидоренко Л.В., 20212021Смирнов Д.Ф., Сидоренко Л.В.Smirnov D.F., Sidorenko L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/747

В период развития гомеостатических систем организма противоопухолевые препараты и облучение поражают как опухолевые клетки, так и здоровые ткани. Повреждение тканей с низким потенциалом восстановительных функций, таких как зубы, обусловливает высокую вероятность необратимых изменений. Целью настоящего обзора литературы является представление информации о стоматологических дефектах, развивающихся в результате противоопухолевого лечения. Наиболее часто аномалии развития зубов включают нарушения количества, размеров, формы, минерализации, дефекты формирования дентина и эмали. На моделях животных изучено влияние ряда химиотерапевтических препаратов: отмечается дефицит и истончение корней зубов, которые имеют место почти у 90 % пациентов. Облучение приводит к более расширенному спектру стоматологической патологии: изменяется целостность зубов, идет процесс формирования черепно-лицевого дисморфизма, формируется постлучевая нижнечелюстная гипомобильность, повреждаются слюнные железы, возрастает риск развития остеорадионекроза челюстей. Степень и тяжесть этих эффектов зависит от возраста ребенка на момент установления диагноза, типа опухоли и дозы облучения. Стадия развития зубов имеет решающее значение. Пациенты, получившие трансплантацию гемопоэтических стволовых клеток (ТГСК) в качестве метода лечения злокачественного новообразования до 3-летнего возраста, имеют более высокий риск возникновения стоматологических нарушений и аномалий развития и роста лица. Лучевая терапия (ЛТ) играет ведущую роль в формировании кариеса. Весь период созревания эмали зубов рассматривается как период высокого риска для развития кариеса. Исследование отдаленных эффектов ЛТ, химиотерапии, ТГСК на развитие стоматологических осложнений представляет интерес для выявления наиболее уязвимых групп пациентов в целях обеспечения возможности раннего вмешательства и улучшения качества жизни.

During the development of the bodyʼs homeostatic systems, anticancer drugs and radiation affect both tumor cells and healthy tissues. Damage to tissues with low potential for restorative functions, such as teeth, leads to a high probability of irreversible changes. The purpose of this literature review is to provide information on dental defects resulting from anticancer treatment. The most common anomalies in the development of teeth include a violation of the number, size, shape, mineralization of teeth, defects of dentin and enamel. The effect of a number of chemotherapeutic drugs has been studied in animal models and include a deficiency and thinning of the roots of the teeth. Irradiation leads to a wider spectrum of dental pathology: the integritation of the teeth changes, craniofacial dysmorphism, post-radiation mandibular hypomobility, damage to the salivary glands, the risk of developing osteoradionecrosis. The extent and severity of these effects depends from the child's age type of tumor and the radiation dose. The stage of tooth development is critical. Patients who received hematopoietic stem cell transplantation (HSCT) before the age of 3 have a higher risk of dental disorders and anomalies in the development and growth of the face. Radiation therapy plays a leading role in the formation of caries. The study of the long-term effects of radiation therapy, chemotherapy, HSCT on the development of dental complications is of interest to identify the most vulnerable groups of patients in order to ensure the possibility of early intervention and improve the quality of life.

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The authors declare that there are no conflicts of interest present.