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Almeida VDSM, Soares MQS, Leite-Ribeiro PM, Rubira-Bullen IRF, Lins-Kusterer LEF, Sarmento VA. Evaluation of Mandibular Bone Microstructure in CT Scans of People with Sickle Cell Disease. Eur J Dent 2024; 18:356-359. [PMID: 37729929 PMCID: PMC10959614 DOI: 10.1055/s-0043-1771200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE Sickle cell disease (SCD) is a common inherited disease, and is characterized by a genetic modification that determines the production of a hemoglobin with altered morphology. This anatomical change of hemoglobin leads to vaso-occlusive disorders and premature hemolysis of the cell, causing chronic anemia and bone marrow hyperplasia due to increased hematopoietic demand. As a consequence, several skeletal changes are reported in the skull, spine, ribs, pelvis, femur, and metatarsals. In the craniofacial region, dentofacial deformities are described, especially maxillary protrusion. However, studies evaluating bone microarchitecture are scarce. The aim of this study is to evaluate the mandibular bone microstructure of people with SCD on computed tomography (CT) scans. MATERIALS AND METHODS Morphometric parameters were analyzed on CT scans of the mandible of people with SCD and people without this disease or any other disease affecting bone metabolism, matched for sex and age. STATISTICAL ANALYSIS The results were compared by Student's t-test for paired samples and for an error probability of 5%. RESULTS This study demonstrated that the mandibular bone of people with SCD presents significantly less number, connectivity and thickness of bone trabeculae, as well as having a lower fractal dimension and greater porosity. CONCLUSION Mandibular bone of people with SCD has lower bone density and more widely spaced trabeculae.
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Prevalence of orofacial alterations in patients with sickle-cell disease: Systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:642-660. [PMID: 36858858 DOI: 10.1016/j.oooo.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to identify the prevalence of orofacial alterations in sickle-cell disease (SCD) and to compare it with the general population. STUDY DESIGN This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The search was conducted on PubMed, Embase, Scientific Electronic Library Online, Web of Science, Cochrane Library, gray literature, and references of the included articles. RESULTS A total of 770 records were found, and 28 studies were selected. In SCD, the prevalence of decreased bone density was 57% (95% CI: 35%-80%), with Q: P < .01 and I2 = 95%; for stepladder pattern was 30% (IC: 13%-47%), Q: P < .01 and I²: 93%; for delayed eruption was 20% (95% CI: 6%-34%), with Q: P < .01 and I2 = 86, Q: P < .01 and I2 = 99%; and for malocclusion, 66% (95% CI: 39%-92%), Q: P < .01 and I2 = 98%. A high risk of bias was observed in relation to the sample size of the studies. A limited number of articles compared the prevalence of orofacial alterations in patients with SCD and healthy individuals. CONCLUSIONS Decreased bone density, malocclusion, orofacial pain, tooth necrosis, eruption delay, periodontal disease, and neuropathies may be present in patients with SCD with variable prevalence.
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Opara NU, Osuala EC, Nwagbara UI. Management of Salter-Harris Type 1 Fracture Complicated with Osteomyelitis in a Sickle Cell Disease Patient: A Case Report and Review of Literature. MEDICINES (BASEL, SWITZERLAND) 2022; 9:medicines9100050. [PMID: 36286583 PMCID: PMC9612152 DOI: 10.3390/medicines9100050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 02/05/2023]
Abstract
Salter-Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter-Harris I fractures of the distal tibia are commonly seen, and management of such fractures are well established in the literature. Despite the availability of a wide range of treatment for such fractures, osteonecrosis or avascular necrosis of the proximal femur can subsequently develop. Avascular necrosis is cell death secondary to metabolic disturbances, trauma, adverse effects of certain medications, or sickle cell disease. Avascular necrosis commonly affects the talus, humerus, or tibia in addition to the femoral head. Radiographic images are essential for prompt diagnosis and to minimize negative health outcomes in these patients. However, Salter-Harris I fracture in sickle cell patients can be very challenging due to these patients' vulnerability to bone infections and sickle cell crisis. In this case report, our patient with a history of sickle cell disease and with a diagnosis of Salter-Harris I fracture was treated with surgical intervention as type V, which is discussed in this article, and responded well to treatment. Thus, this case suggests a new approach to managing Salter-Harris I fractures complicated with osteomyelitis in sickle cell patients.
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Affiliation(s)
- Nnennaya U. Opara
- Department of Emergency Medicine, Charleston Area Medical Center Institute for Academic Medicine, Charleston, WV 25304, USA
- Department of Health Administration, University of Phoenix, Phoenix, AZ 85040, USA
- Correspondence:
| | - Emmanuella C. Osuala
- Department of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal Westville Campus, Durban 4000, South Africa
| | - Ugochinyere I. Nwagbara
- Department of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban 4041, South Africa
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Orofacial Manifestation and Dental Management of Sickle Cell Disease: A Scoping Review. Anemia 2021; 2021:5556708. [PMID: 34721900 PMCID: PMC8556080 DOI: 10.1155/2021/5556708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/13/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
Aims Sickle cell disease (SCD) is an upcoming global health problem with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on the dental treatment of sickle cell disease (SCD). This article aims to outline the oral features of the sickle disease and discuss oral management strategies that can serve as guidelines for dental professionals. Material and Methods. A comprehensive literature review was conducted using PubMed, Google Scholar, and Web of Science. The search strategies were developed to cover publications from January 2010 to March 2020. With the help of keywords, multiple abstracts were identified. These abstracts were further reviewed, which included the information about the SCD manifestation, particularly about the oral health features. Based on all these articles and clinical experience, a narrative review was constructed, which summarizes all the aspects of the oral manifestation in people with SCD. Results The results of this study demonstrate that there is distinct evidence available, indicating the developmental enamel defect leading to hypoplasia and increasing susceptibility to dental caries. Another important result of this review found that people with SCD have a vaso-occlusive crisis in the microcirculation in the dental pulp leading to symptomatic and asymptomatic pulpal necrosis without any signs of odontogenic pathology in an apparently healthy tooth. The study also found that early detection, intervention, and prevention are crucial for improving oral health care, and involving a multidisciplinary approach plays an important role in managing people with SCD. Conclusion Patients with sickle cell disease have chronic overall health problems. The hematological disorder becomes their main concern and impaired oral health becomes secondary, increasing the risk for dental caries at the most. This paper broadly describes the oral manifestations of SCD, additionally; this paper also provides recommendations for better dental management of patients with SCD. Patients with SCD are often misjudged and, due to lack of knowledge and guidelines, dental providers are not able to provide adequate care. This paper attempts to highlight the essential measures to provide better dental care.
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Investigation of the relationship between periodontal and systemic inflammation in children with Sickle Cell Disease: A case- control study. Cytokine 2021; 149:155724. [PMID: 34653827 DOI: 10.1016/j.cyto.2021.155724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/26/2021] [Accepted: 09/30/2021] [Indexed: 11/20/2022]
Abstract
Periodontal diseases are chronic inflammatory diseases and tissue destruction increases with oxidative stress in periodontal tissues. Periodontal diseases are associated with systemic diseases such as diabetes, cardio-vascular diseases and rheumatoid arthritis by means of systemic inflammation. Sickle cell disease (SCD) is a chronic inflammatory disease in which vaso-occlusive crisis and endothelial dysfunction are present. It is not known whether the chronic systemic inflammation seen in SCD affect periodontal tissues. The aim of this study was to investigate the relationship between periodontal and systemic inflammation in children with SCD. Forty-three children with SCD and 43 healthy children were included in the study. Physical, dental and periodontal statuses were examined, blood and saliva samples were taken. Levels of pro-inflammatory and oxidative stress mediators in serum and saliva were evaluated. The periodontal findings of the groups were similar. The majority of the subjects in both groups had gingival inflammation. In SCD group, significantly higher serum high sensitive C-reactive protein (Hs-CRP), interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, total oxidant status (TOS), nitric oxide (NO) and salivary IL-6 were observed (p < 0.05). There were positive correlations between salivary IL-6 levels and serum Hs-CRP levels (r = 0.303, p < 0.05). In addition; it was determined that salivary IL-6, TNF-α and NO levels were increased 3-6 times in children with a history of painful crisis or acute chest syndrome compared to children who had never had a painful crisis or acute chest syndrome. Although, observed oral health status was similar in both groups, salivary cytokine levels were increased in children with SCD. The higher salivary cytokine levels may be associated with chronic systemic inflammation and vaso-occlusion observed in children with SCD.
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Mechanisms of Bone Impairment in Sickle Bone Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041832. [PMID: 33668588 PMCID: PMC7918363 DOI: 10.3390/ijerph18041832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
Sickle bone disease (SBD) is a chronic and invalidating complication of Sickle cell disease (SCD), a multisystem autosomal recessive genetic disorder affecting millions of people worldwide. Mechanisms involved in SBD are not completely known, especially in pediatric age. Among the hypothesized pathogenetic mechanisms underlying SBD are bone marrow compensatory hyperplasia and bone ischemic damage, both secondary to vaso-occlusive crisis (VOC), which leads to cell sickling, thus worsening local hypoxia with a negative impact on osteoblast recruitment. Furthermore, the hypoxia is a strong activator of erythropoietin, which in turn stimulates osteoclast precursors and induces bone loss. Hemolysis and iron overload due to a chronic transfusion regimen could also contribute to the onset of bone complications. Vitamin D deficiency, which is frequently seen in SCD subjects, may worsen SBD by increasing the resorptive state that is responsible for low bone mineral density, acute/chronic bone pain, and high fracture risk. An imbalance between osteoblasts and osteoclasts, with a relative decrease of osteoblast recruitment and activity, is a further possible mechanism responsible for the impairment of bone health in SCD. Moreover, delayed pubertal growth spurt and low peak bone mass may explain the high incidence of fracture in SCD adolescents. The aim of this review was to focus on the pathogenesis of SBD, updating the studies on biochemical, instrumental, and biological markers of bone metabolism. We also evaluated the growth development and endocrine complications in subjects affected with SCD.
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Orofacial manifestations of sickle cell disease: implications for dental clinicians. Br Dent J 2021; 230:143-147. [PMID: 33574535 DOI: 10.1038/s41415-021-2601-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/07/2020] [Indexed: 11/08/2022]
Abstract
Sickle cell disease is a multisystem disease associated with episodes of acute illness and progressive organ damage. It is one of the most common severe monogenic disorders worldwide and is now the fastest growing genetic disorder in the UK. Dental awareness of orofacial manifestation varies geographically due to the inheritance pattern and patient population affected by the disease. This article details the epidemiology, pathophysiology and the orofacial manifestations in light of current literature.
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Pigg M, Nixdorf DR, Law AS, Renton T, Sharav Y, Baad-Hansen L, List T. New International Classification of Orofacial Pain: What Is in It For Endodontists? J Endod 2020; 47:345-357. [PMID: 33340605 DOI: 10.1016/j.joen.2020.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/14/2020] [Accepted: 12/09/2020] [Indexed: 12/15/2022]
Abstract
Pain is a common symptom in endodontic conditions, but differential diagnostic procedures are often needed to exclude other pain origins. Thus, general dentists and endodontists need to be aware of alternative painful orofacial conditions and be able to identify them. The new International Classification of Orofacial Pain (ICOP) is the first comprehensive classification that uniquely deals with orofacial pain. The ICOP is a hierarchical classification modeled on the International Classification of Headache Disorders and covers pain in dentoalveolar and anatomically related tissues, muscle pain, temporomandibular joint pain, neuropathic pain affecting cranial nerves, pain resembling primary headaches, and idiopathic pain in the orofacial region. A description of each condition is given, and structured diagnostic criteria for each condition are proposed based on research data when available. This narrative review aims (1) to give an overview and brief explanation of the ICOP system, (2) to describe and give examples of how it can be of use to general dentists and endodontists with special attention to differential diagnosis of tooth pain, and (3) to highlight how endodontic research can contribute to validation and improvement of the classification. A comparison to other classification and diagnostic systems is also included.
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Affiliation(s)
- Maria Pigg
- Department of Endodontics, Malmö University, Malmö, Sweden; Scandinavian Centre for Orofacial Neurosciences, Aarhus, Denmark.
| | - Donald R Nixdorf
- Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minnesota; Department of Neurology, University of Minnesota, Minnesota; Department of Radiology, Medical School, University of Minnesota, Minnesota
| | - Alan S Law
- Division of Endodontics, School of Dentistry, University of Minnesota, Minnesota; Private Practice, The Dental Specialists, Lake Elmo, Minnesota
| | - Tara Renton
- Oral Surgery, Centre for Oral, Clinical and Translational Sciences, King's College Hospital, London, United Kingdom; Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, United Kingdom
| | - Yair Sharav
- Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Lene Baad-Hansen
- Scandinavian Centre for Orofacial Neurosciences, Aarhus, Denmark; Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark
| | - Thomas List
- Scandinavian Centre for Orofacial Neurosciences, Aarhus, Denmark; Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
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Gusmini MADS, De Sa AC, Feng C, Arany S. Predictors of dental complications post-dental treatment in patients with sickle cell disease. Clin Exp Dent Res 2020; 7:11-19. [PMID: 33225591 PMCID: PMC7853884 DOI: 10.1002/cre2.335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/16/2020] [Accepted: 09/27/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Our aim was to explore potential medical or dental indicators associated with dental complications and the utilization of emergency services in sickle cell disease (SCD), especially that clinical reports on adverse outcomes post‐dental treatment are scarce. Materials and methods A retrospective analysis of dental treatments of 47 eligible adults with confirmed SCD between May 2016 and October 2019. Logistic regression analysis was used whether clinical outcomes, course of dental treatment, and regularity of dental care are associated with dental complications after dental procedures and/or resulted in emergency care or hospital admissions. Results We identified a new, statistically significant association (p‐value = .01) between the number of prescription medications taken and complications (10%) after dental procedures. The most frequent dental procedures were tooth extractions (36%) and pain management (28%) during a non‐scheduled dental encounter (68%). The majority of cases did not participate in regular recall exams and periodical oral hygiene maintenance. Conclusions A higher number of prescription medications was associated with an increased risk of post‐dental complications in SCD patients. A thorough medical history, including a list of prescribed medications, and collaboration with the patient medical team are important to assess the risk of complications post‐dental procedures and the need for antibiotic prophylaxis according to the case complexity.
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Affiliation(s)
| | - Anny Clementino De Sa
- Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Szilvia Arany
- Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
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Evidence-based dental management in the new era of sickle cell disease: A scoping review. J Am Dent Assoc 2020; 151:668-677.e9. [PMID: 32854869 DOI: 10.1016/j.adaj.2020.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is an emerging global health issue with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on dental treatment of SCD. TYPES OF STUDIES REVIEWED Using a scoping review approach, the authors examined citations from 13 national SCD guidelines and 10 books spanning 4 decades. The authors also searched the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Scientific Electronic Library Online, and GoogleScholar. Eligibility criteria included SCD, oral health care and dental treatment, related to oral and systemic health, original data, or observations. RESULTS Systemic treatment of SCD might have opposing effects on caries, perhaps explaining the conflicting results published. Malocclusion correlates with marrow expansion. Other unusual orofacial findings reflect ischemia. Of 86 full-text articles examined, only 1, a Brazilian esthetic dentistry study, was a randomized clinical trial. No disease-specific data were found on risk of developing bacterial endocarditis, safety of inhaled nitrous oxide, safety of epinephrine with local anesthetic, or the benefit of comprehensive oral health care. PRACTICAL IMPLICATIONS In SCD, oral health and systemic health could be strongly linked. Penicillin, vaccines, and hydroxyurea might impact caries and bone. The interaction of SCD treatments and oral health merit study.
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Costa CPS, Thomaz ÉBAF, Ribeiro CCC, Souza SDFC. Biological factors associating pulp necrosis and sickle cell anemia. Oral Dis 2020; 26:1558-1565. [DOI: 10.1111/odi.13415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/12/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health. Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. This is an update of a previously published review. OBJECTIVES To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Review Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 01 August 2019. Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field. Date of last search: 07 November 2019. SELECTION CRITERIA We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS No randomised controlled studies were identified. AUTHORS' CONCLUSIONS This Cochrane Review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.
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Affiliation(s)
- Priti Mulimani
- School of Dentistry, University of WashingtonOral Health Sciences1959 Pacific Street NESeattleWAUSA98195
| | - Samir K Ballas
- Jefferson Medical College, Thomas Jefferson UniversityCardeza Foundation for Hematologic Research, Department of Medicine1015 Walnut StreetPhiladelphiaPAUSA19107‐5099
| | - Adinegara BL Abas
- Melaka‐Manipal Medical College (Manipal Academy of Higher Education)Department of Community MedicineJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Laxminarayan Karanth
- Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Obstetrics and GynaecologyBukit Baru, Jalan BatuHamparMelakaMalaysia75150
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Abstract
The US Surgeon General's report Oral Health in America highlighted ways in which oral health and systemic conditions are associated with each other. An oral examination can reveal signs and symptoms associated with systemic diseases. In this article, multiple systemic diseases including but not limited to viral and immune modulated conditions and associated oral symptoms are discussed.
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Affiliation(s)
- Natasha Bhalla
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.
| | - Yoav Nudell
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Jaykrishna Thakkar
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Harry Dym
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
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Evaluation of Mandible Fractures in Patients With Sickle Cell Anemia-A Nationwide Study. J Oral Maxillofac Surg 2019; 77:1418-1422. [PMID: 30707980 DOI: 10.1016/j.joms.2018.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/27/2018] [Accepted: 12/27/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE Sickle cell anemia is the most commonly inherited blood disorder in the United States. Despite its prevalence, clinicians know little about the extent of its impact on orofacial manifestations. MATERIALS AND METHODS All patients with diagnoses of mandible fracture and sickle cell anemia admitted from 2004 through 2014 were identified using the National Inpatient Sample. Patient demographics, fracture regions, and complications were characterized by descriptive statistics. RESULTS Fifty-one of 48,464 patients admitted for mandible fracture had sickle cell anemia. The mean age of the identified patients was 25 years (range, 4 to 58 yr). Of all admitted patients, mandible angle fracture was the most common (19%), followed by fracture of the body of the mandible. Seventy-five percent of cases reviewed were treated with open reduction and internal fixation. CONCLUSIONS Most mandible fractures in patients with sickle cell anemia were located in the angle of the mandible. Complications were minimal and outcomes were satisfactory. Aseptic necrosis of the jaw was a frequent complication of mandible fracture in patients with sickle cell anemia. These results provide clinicians with a better understanding of the distribution and hospital course of patients with sickle cell anemia and facial fractures.
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Abstract
Newer research tools and basic science knowledge base have allowed the exploration of endodontic diseases in the pulp and periapical tissues in novel ways. The use of next generation sequencing, bioinformatics analyses, genome-wide association studies, to name just a few of these innovations, has allowed the identification of hundreds of microorganisms and of host response factors. This review addresses recent advances in endodontic microbiology and the host response and discusses the potential for future innovations in this area.
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Affiliation(s)
- Ashraf F Fouad
- Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill, 1098 First Dental Building, CB# 7450, Chapel Hill, NC 27599-7450, USA.
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16
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dos Santos HLR, Barbosa IDS, de Oliveira TFL, Sarmento VA, Trindade SC. Evaluation of the maxillomandibular positioning in subjects with sickle-cell disease through 2- and 3-dimensional cephalometric analyses: A retrospective study. Medicine (Baltimore) 2018; 97:e11052. [PMID: 29923994 PMCID: PMC6023795 DOI: 10.1097/md.0000000000011052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sickle-cell disease (SCD), which involves morphological changes to the red blood cells, is the most common hemoglobinopathy worldwide. This conformational change in erythrocytes affects multiple organs and systems, including the hard and soft tissues of the stomatognathic system. The objective of this study was to provide a description of the maxillomandibular positioning of patients using computed tomography in a case series of 40 patients with SCD. To define the facial profile of patients, 2-dimensional (2D) and 3-dimensional (3D) McNamara and Steiner cephalometric tracings were performed. The results showed that there is a tendency to maxillary protrusion in 2D and 3D analyses. There was no statistical difference between the 2D and 3D evaluations; additionally, sex affected the maxillomandibular positioning of patients, but only in McNamara evaluations.
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Affiliation(s)
| | | | | | - Viviane Almeida Sarmento
- State University of Feira de Santana, Salvador, Bahia
- Federal University of Bahia, Salvador, Brazil
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Kawar N, Alrayyes S, Aljewari H. Sickle cell disease: An overview of orofacial and dental manifestations. Dis Mon 2018; 64:290-295. [PMID: 29338872 DOI: 10.1016/j.disamonth.2017.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nadia Kawar
- Diplomate, American Board of Periodontology, USA; Clinical Associate Professor, Department of Periodontology, College of Dentistry, University of Illinois, USA.
| | - Sahar Alrayyes
- Diplomate, American Board of Pediatric Dentistry, USA; Clinical Associate Professor, Department of Pediatric Dentistry, College of Dentistry, University of Illinois, USA
| | - Haider Aljewari
- Postgraduate Periodontics Program, College of Dentistry, University of Illinois, USA
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18
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Healthy Dental Pulp Oxygen Saturation Rates in Subjects with Homozygous Sickle Cell Anemia: A Cross-Sectional Study Nested in a Cohort. J Endod 2017; 43:1997-2000. [DOI: 10.1016/j.joen.2017.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/11/2017] [Accepted: 07/16/2017] [Indexed: 11/23/2022]
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19
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Souza SFC, de Carvalho HLCC, Costa CPS, Thomaz EBAF. Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities. Oral Dis 2017; 24:393-403. [DOI: 10.1111/odi.12742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 01/01/2023]
Affiliation(s)
- SFC Souza
- Department of Dentistry; Federal University of Maranhão; São Luıs Brazil
| | - HLCC de Carvalho
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luıs Brazil
| | - CPS Costa
- Postgraduate Dentistry Program; Federal University of Maranhão; São Luıs Brazil
| | - EBAF Thomaz
- Department of Public Health; Federal University of Maranhão; São Luıs Brazil
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Abstract
BACKGROUND Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health.Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. OBJECTIVES To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.Date of last search: 11 April 2016.Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field.Date of last search: 03 March 2016. SELECTION CRITERIA We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS No randomised controlled studies were identified. AUTHORS' CONCLUSIONS This Cochrane review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.
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Affiliation(s)
- Priti Mulimani
- Department of Orthodontics, Melaka-Manipal Medical College, Jalan Batu Hampar, Bukit Baru, Malaysia, India, 75150
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Thayil N, Chapman MN, Saito N, Fujita A, Sakai O. Magnetic Resonance Imaging of Acute Head and Neck Infections. Magn Reson Imaging Clin N Am 2016; 24:345-67. [PMID: 27150323 DOI: 10.1016/j.mric.2015.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article discusses the use of MR imaging in various acute infectious diseases of the head and neck, with particular emphasis on situations where MR imaging provides additional information that can significantly impact treatment decisions and outcomes. MR imaging findings of various disease processes are discussed, based on the head and neck compartments from which they originate. Specifically, infectious entities of the orbit, paranasal sinuses, pharynx, oral cavity (including periodontal disease), salivary glands, temporal bone, and lymph nodes are described in detail.
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Affiliation(s)
- Neil Thayil
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA
| | - Margaret N Chapman
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA; Radiology Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, USA
| | - Naoko Saito
- Department of Radiology, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Akifumi Fujita
- Department of Radiology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA.
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FERREIRA SBP, TAVARES WLF, ROSA MACD, BRITO LCND, VIEIRA LQ, MARTELLI JÚNIOR H, RIBEIRO SOBRINHO AP. Sickle cell anemia in Brazil: personal, medical and endodontic patterns. Braz Oral Res 2016; 30:S1806-83242016000100255. [DOI: 10.1590/1807-3107bor-2016.vol30.0060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 11/22/2015] [Indexed: 12/15/2022] Open
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Gadallah N, El Hefnawy H, Ahmed SF, Ali J, Mahdy A. Trigeminal nerve electrophysiological assessment in sickle cell anemia: correlation with disease severity and radiological findings. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2015. [DOI: 10.4103/1110-161x.157865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Periapical cytokine expression in sickle cell disease. J Endod 2015; 41:358-62. [PMID: 25576201 DOI: 10.1016/j.joen.2014.11.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 09/08/2014] [Accepted: 11/26/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Sickle cell anemia (SCA) is the most prevalent genetic disease worldwide. Patients with SCA exhibit increased levels of proinflammatory mediators as part of a permanently activated immunoinflammatory status. METHODS The aim of this study was to evaluate the mRNA expression levels of the cytokines interferon (IFN-γ), tumor necrosis factor, interleukin (IL-1β, IL-17A, IL-10), receptor activator for nuclear factor kappa B ligand, and the chemokines CCL2/MCP-1 and CCL5 in the periapical interstitial fluid from SCA individuals compared with healthy individuals. Samples were collected from 12 teeth of SCA patients and 12 non-SCA patients with apical periodontitis. In addition, 12 teeth were sampled from the periapical region of healthy patients with vital pulp (control). The expression of cytokine mRNA was detected by using real-time polymerase chain reaction. RESULTS The expression of mRNA for the Th1-associated cytokines IFN-γ, tumor necrosis factor-α, and IL-1β were significantly higher in SCA individuals than in the control individuals (P < .05). Among Th1-associated cytokines, only IFN-γ was significantly increased in non-SCA compared with control patients (vital pulp). The expression of IL-17A mRNA was significant higher in SCA cases than in control samples (P < .05), whereas the IL-10 mRNA expression was significantly increased in SCA and non-SCA individuals when compared with the control group. Similar levels of receptor activator for nuclear factor kappa B ligand, CCL2, and CCL5 mRNA expression were observed in all samples. However, no significant differences were observed in the expression of cytokine or chemokine mRNA between SCA and non-SCA individuals (P > .05). CONCLUSIONS The results were able to demonstrate that SCA patients presented prone proinflammatory ability, despite the fact that any differences in periapical immune responses between SCA and non-SCA individuals were not observed.
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Al-Alawi H, Al-Jawad A, Al-Shayeb M, Al-Ali A, Al-Khalifa K. The association between dental and periodontal diseases and sickle cell disease. A pilot case-control study. Saudi Dent J 2014; 27:40-3. [PMID: 25544813 PMCID: PMC4273253 DOI: 10.1016/j.sdentj.2014.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 07/15/2014] [Accepted: 08/27/2014] [Indexed: 01/22/2023] Open
Abstract
Objective This is a pilot case-control study conducted to investigate the prevalence of dental caries and periodontal disease and examine the possible association between oral health deterioration and SCD severity in a sample of Saudi SCD patients residing in the city of Al-Qatif, Eastern Province, Saudi Arabia. Materials and methods Dental examination to determine the Decayed, Missing and Filled Teeth index (DMFT), Community Periodontal Index (CPI), and plaque index system were recorded for 33 SCD patients and 33 age and sex-matched controls in the Al-Qatif Central Hospital, Qatif, Saudi Arabia. Self-administered surveys used to assess socio-economic status; oral health behaviors for both SCD patients and controls were recorded. In addition, the disease severity index was established for all patients with SCD. SPSS data analysis software package version 18.0 was used for statistical analysis. Numerical variables were described as mean with a standard deviation. Results Decayed teeth were significantly more in individuals with ages ranging from 18 to 38 years with SCD compared to the control group (p = 0.036) due to oral hygiene negligence. The mean number of filled teeth was significantly lower in individuals with SCD when compared to the control group (p = 0.015) due to the lack of appropriate and timely treatment reflected in the survey responses of SCD patients as 15.2% only taking oral care during hospitalization. There were differences between the cases and controls in the known caries risk factors such as income level, flossing, and brushing habit. The DMFT, CPI, and plaque index systems did not differ significantly between the SCD patients and the control group. Conclusion Data suggest that patients with SCD have increased susceptibility to dental caries, with a higher prevalence of tooth decay and lower prevalence of filled teeth. Known caries risk factors influenced oral health more markedly than did factors related to SCD.
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Affiliation(s)
- Haidar Al-Alawi
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | | | - Mahdi Al-Shayeb
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Ali Al-Ali
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
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Basati MS. Sickle cell disease and pulpal necrosis: a review of the literature for the primary care dentist. Prim Dent J 2014; 3:76-79. [PMID: 25198336 DOI: 10.1308/205016814812135922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A case of difficult diagnosis of a patient with sickle cell disease and tooth pain fuelled a literature review by a primary care general dental practitioner. A literature search was conducted to review the relationship between sickle cell disease and pulpal necrosis. The results indicated statistically significant associations of sickle cell disease and tooth pain without any carious or traumatic pathology. It is important for the primary care dentist to be aware of the relationship between sickle cell disease and pulpal necrosis to prevent misdiagnosis and consequently mistreatment.
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Meeuwes M, Souza de Carvalho TF, Cipolotti R, Gurgel RQ, Ferrão TO, Peters M, Agyemang C. Bone mineral density, growth, pubertal development and other parameters in Brazilian children and young adults with sickle cell anaemia. Trop Med Int Health 2013; 18:1539-46. [DOI: 10.1111/tmi.12211] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Meeuwes
- Department of Public Health; Academic Medical Centre, University of Amsterdam; Amsterdam The Netherlands
| | - T. F. Souza de Carvalho
- Department of Medicine and Post Graduate Nucleus of Medicine; Federal University of Sergipe; Aracaju Brazil
| | - R. Cipolotti
- Department of Medicine and Post Graduate Nucleus of Medicine; Federal University of Sergipe; Aracaju Brazil
| | - R. Q. Gurgel
- Department of Medicine and Post Graduate Nucleus of Medicine; Federal University of Sergipe; Aracaju Brazil
| | - T. O. Ferrão
- Department of Medicine and Post Graduate Nucleus of Medicine; Federal University of Sergipe; Aracaju Brazil
| | - M. Peters
- Department of Pediatric Hematology; Emma Children's Hospital, AMC; Amsterdam The Netherlands
| | - C. Agyemang
- Department of Public Health; Academic Medical Centre, University of Amsterdam; Amsterdam The Netherlands
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Abstract
BACKGROUND The aim of this study was to review the orofacial manifestations in patients with sickle cell disease (SCD). METHODS Indexed databases were explored using various combinations of the following keywords: "sickle cell anemia," "sickle cell disease," "oral health status" and "dental inflammation." RESULTS Hypoxia has been associated with osteomyelitis of the jaws, particularly the mandible in patients with SCD. Bone marrow hyperplasia in these patients causes depression of nasal bridge, midfacial overgrowth and malocclusion. Mental nerve neuropathy due to osteomyelitis of the mandible causes numbness in the lower lip and chin. A diminished blood supply to teeth causes necrosis of the dental pulp in patients with SCD. Dental caries is a common manifestation in patients with SCD, particularly in those with underprivileged living standards. The association between SCD and periodontal inflammatory conditions remains unclear. CONCLUSIONS Oral health problems in patients with SCD are rare and occur mainly as a result of the poor oral hygiene maintenance.
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Caracas MDS, Jales SP, Neto LHJ, da Silva Castro JC, Suganuma LM, Fonseca GHH, Gualandro SFM, de Siqueira JTT. Temporomandibular joint arthritis in sickle cell disease: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e31-5. [DOI: 10.1016/j.oooo.2012.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 05/12/2012] [Accepted: 05/18/2012] [Indexed: 11/25/2022]
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Costa CPS, Thomaz EBAF, Souza SDFC. Association between Sickle Cell Anemia and Pulp Necrosis. J Endod 2013; 39:177-81. [DOI: 10.1016/j.joen.2012.10.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Revised: 10/11/2012] [Accepted: 10/18/2012] [Indexed: 11/26/2022]
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Costa CPS, de Carvalho HLCC, Thomaz EBAF, Sousa SDFC. Craniofacial bone abnormalities and malocclusion in individuals with sickle cell anemia: a critical review of the literature. Rev Bras Hematol Hemoter 2012; 34:60-3. [PMID: 23049386 PMCID: PMC3459599 DOI: 10.5581/1516-8484.20120016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/31/2011] [Indexed: 11/27/2022] Open
Abstract
This study aims to critically review the literature in respect to craniofacial bone abnormalities and malocclusion in sickle cell anemia individuals. The Bireme and Pubmed electronic databases were searched using the following keywords: malocclusion, maxillofacial abnormalities, and Angle Class I, Class II and lass III malocclusions combined with sickle cell anemia. The search was limited to publications in English, Spanish or Portuguese with review articles and clinical cases being excluded from this study. Ten scientific publications were identified, of which three were not included as they were review articles. There was a consistent observation of orthodontic and orthopedic variations associated with sickle cell anemia, especially maxillary protrusions. However, convenience sampling, sometimes without any control group, and the lack of estimates of association and hypotheses testing undermined the possibility of causal inferences. It was concluded that despite the high frequency of craniofacial bone abnormalities and malocclusion among patients with sickle cell anemia, there is insufficient scientific proof that this disease causes malocclusion
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Neves FS, Oliveira LSAF, Torres MGG, Toralles MBP, da Silva MCBO, Campos MIG, Campos PSF, Crusoé-Rebello I. Evaluation of panoramic radiomorphometric indices related to low bone density in sickle cell disease. Osteoporos Int 2012; 23:2037-42. [PMID: 22006042 DOI: 10.1007/s00198-011-1810-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/04/2011] [Indexed: 11/30/2022]
Abstract
SUMMARY In sickle cell disease, erythroid hyperplasia causes trabecular destruction leading to low bone density. This condition could be suspected by the radiomorphometric indices and your diagnosis becomes relevant in a multidisciplinary context of health care for sickle cell subjects, providing prognostics and contributing to determine adequate therapeutic and preventive actions. INTRODUCTION The aim of this study was to assess the risk of low bone density in subjects with sickle cell disease (SCD) through analysis of panoramic radiographic exams by radiomorphometric indices. METHODS Seventy-eight Brazilian subjects with SCD took part in this study and were subdivided into four groups: (I) 31 SCD subjects aged under 40 years; (II) 13 SCD subjects aged 40 years or more; (III) 12 normal subjects aged under 40 years; and (IV) 22 normal subjects aged 40 years or more. In the panoramic radiographs, the mandibular cortical index (MCI) classification, increased spacing of the trabecular bone, panoramic mandibular index (PMI), and mental index (MI) were evaluated. Exact Fisher's test was used to compare age between the different groups. Descriptive analysis of the data was performed to evaluate the simple visual estimation of low bone density (increased bone trabecular space and MCI), and a one-way analysis of variance (Bonferroni criteria) was used to compare the means of the quantitative indices (PMI and MI). The significance level was p < 0.05. RESULTS In the MCI classification, C2 was more prevalent, especially in groups I and IV. Increased spacing of the trabecular bone was more frequent in groups I and II. MI did not show a statistically significant difference among the groups. PMI showed a statistically significant difference only between groups III and IV. CONCLUSIONS The radiomorphometric indices applied in the present study can be used on panoramic radiographs to detect the presence of low bone density in SCD subjects.
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Affiliation(s)
- F S Neves
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Av Limeira, 901, Areião, Piracicaba, São Paulo, Brazil, 13414-018.
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Passos CP, Santos PRB, Aguiar MC, Cangussu MCT, Toralles MBP, da Silva MCBO, Nascimento RJM, Campos MIG. Sickle cell disease does not predispose to caries or periodontal disease. SPECIAL CARE IN DENTISTRY 2012; 32:55-60. [DOI: 10.1111/j.1754-4505.2012.00235.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Guzeldemir E, Toygar HU, Boga C, Cilasun U. Dental and periodontal health status of subjects with sickle cell disease. J Dent Sci 2011. [DOI: 10.1016/j.jds.2011.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Neves FS, de Almeida DA, Oliveira-Santos C, dos Santos JN, Toralles MBP, da Silva MCBO, Campos MIG, Crusoé-Rebello I. Radiographic changes of the jaws in HbSS and HbSC genotypes of sickle cell disease. SPECIAL CARE IN DENTISTRY 2011; 31:129-33. [DOI: 10.1111/j.1754-4505.2011.00195.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor. Clin Oral Investig 2011; 16:827-33. [DOI: 10.1007/s00784-011-0577-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 05/26/2011] [Indexed: 12/26/2022]
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Saito N, Nadgir RN, Flower EN, Sakai O. Clinical and Radiologic Manifestations of Sickle Cell Disease in the Head and Neck. Radiographics 2010; 30:1021-34. [DOI: 10.1148/rg.304095171] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mandibular bone changes in sickle cell anemia: fractal analysis. ACTA ACUST UNITED AC 2008; 106:e41-8. [DOI: 10.1016/j.tripleo.2008.03.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 03/07/2008] [Indexed: 11/17/2022]
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Abstract
Bone involvement is the commonest clinical manifestation of sickle cell disease both in the acute setting such as painful vaso-occlusive crises, and as a source of chronic, progressive disability such as avascular necrosis. Management of these problems is often difficult because of the diagnostic imprecision of most laboratory and imaging investigations and because of the lack of evidence for most surgical procedures in sickle cell disease. This review first discusses the acute problems related to bone involvement in sickle cell disease, with particular reference to differentiating infection from infarction, and then describes the long-term effects of sickle cell disease on bone mineral density, growth, and chronic bone and joint damage.
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Affiliation(s)
- Antonio Almeida
- Department of Haematology, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK.
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