ÇOCUKLUK ÇAĞI KANSERİ TEDAVİSİ GÖRMÜŞ HASTALARDA ORTODONTİK TEDAVİ YAKLAŞIMLARI : SİSTEMATİK DERLEME

Yıl 2023, Cilt: 9 Sayı: 2, 59 - 67, 31.08.2023

İpek Şavkan , Evren Öztaş

Öz

Günümüzde gelişen tedavi yöntemlerinin de etkisiyle pediatrik dönemde kanser tanısı almış hastaların tedavilerinde olumlu sonuçlar elde edilmekte, bununla birlikte sağkalım oranları ve beklenen yaşam süresi artmakta, dolayısıyla bu hastaların yaşam kalitelerinin arttırılması önem kazanmaktadır. İyileşme oranlarındaki artış ile birlikte bu hastaların ortodontik tedavi talepleri de artmaktadır. Bu derlemenin amacı iyileşmiş pediatrik onkoloji hastalarında ortodontik tedavi planlaması ve uygulanmasında dikkat edilmesi gereken hususların incelenmesi ve kliniğe yönelik bir rehber sunulmasıdır. Onkolojik tedavilerde kullanılan kemoterapötik ilaçların büyümeyi baskılayıcı etkisi ile büyüme-gelişim çağındaki çocuklarda dental ve kraniofasiyal yapılarda bir takım değişiklikler meydana gelmektedir. Hastanın tedavi gördüğü döneme bağlı olarak diş yapısında da mine, kök defektleri, şekil anomalilerine rastlanabilmektedir. Bu noktada ortodontik tedavi dental gelişim yetersizlikleri ve büyümedeki farklılıklar düşünülerek tedavi planlanmalı ve yürütülmelidir. Çocukluk çağı kanser hastalarında ortodontik tedavilerde en önemli kriter tedavi zamanlaması olup, tanı almış bir hastada hiçbir koşulda ortodontik tedaviye başlanılmaz, eğer başlanılmış ise tedavi sonlandırılır. Bu hastalarda sadece onkolojik tedavi tamamlandıktan sonra ve belli koşullar altında ortodontik tedavi uygulamaları yapılabilir. Ortodontik tedavi esnasında mukozal irritasyon ve kök rezorpsiyonu gibi yan etkiler görülebileceği akılda tutulmalıdır. Ortodontik tedaviye aktif kanser tedavisinin tamamlanmasından minimum 2 yıl sonra başlanmalı, olası riskleri minimize etmek amacıyla düşük kuvvetlerle çalışılmalı ve gerekli durumlarda tedavinin ideale ulaşmadan bitirilmesi kabul edilmelidir.

Anahtar Kelimeler

pediatrik onkoloji, dişhekimliği, ortodonti

Kaynakça

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