IntroductionOral symptoms are often the first manifestation of leukemia in children, and there are many reports of tooth extraction for abnormalities such as tooth movement. Leukemia accounts for 38% of all childhood cancers in Japan, followed by brain tumors (16%), lymphomas (9%), and neuroblastomas (AML) (8%), and the remaining 5% are unknown. Among the types of acute lymphoblastic leukemia (ALL), B-cell acute lymphoblastic leukemia (B-ALL) accounts for 80–85% and T-cell acute lymphoblastic leukemia (T-ALL) about 10–15%.1Marukawa et al. reported that approximately 20–35% of leukemia patients have initial symptoms in the oral cavity, and it is not uncommon for oral symptoms to appear early in the course of leukemia. The most common oral symptoms in leukemia patients are gingival hemorrhage and gingival swelling, followed by jawbone abnormalities such as miconus hypersensitivity, alveolar bone resorption, and tooth movement, and many cases of leukemia have been detected in the oral cavity.2-8Curtis et al. reported a correlation between leukemia and mild or worsening jaw bone symptoms in pediatric patients with ALL, based on radiographic studies of jaw bone changes. However, there are no reports of cases of jaw bone resorption in patients with ALL in Japan, although there are a few reports of cases in which jaw bone resorption was observed due to leukemia cell infiltration following the onset of leukemia. No cases have been reported in which the jawbone was severely resorbed.9, 10In this study, we report a case of a pediatric patient with ALL who developed leukemia and had significant jaw bone resorption due to infiltration of leukemia cells, resulting in severe tooth movement and the inability to properly occlude the jaw.
