CRANIOMANDIBULAR DYSFUNCTION IN CHILDREN TREATED WITH TOTAL-BODY IRRADIATION AND BONE-MARROW TRANSPLANTATION

The prevalence of pain and dysfunction in the stomatognathic system wa s studied in a group of 19 long-term survivors after pediatric bone ma rrow transplantation (BMT), conditioned with total-body irradiation (T BI). Compared with the control group, the children and adolescents in the BMT group had a significantly reduced mouth opening capacity. A re duced translation movement of the condyles was diagnosed in 53% of chi ldren treated with TBI, compared with 5% in the control group. Signs o f craniomandibular dysfunction were found in 84% of children in the BM T group, compared with 58% in the control group. Both irradiation and chemotherapy induce long-term alterations in connective and muscle tis sues resulting in inflammation and eventually fibrosis. These changes in tissue homeostasis and concomitant growth retardation may lead to t he observed malocclusion and reduced mobility of the temporomandibular joint, with subsequent muscle pain and headaches, which were found in this study.