Dental Caries in Children with Sickle Cell Disease and Its Association with the Use of Hydroxyurea and Penicillin Prophylaxis in Dar Es Salaam

Purpose

This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants.

Methods

This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record sociodemographic details including mean age in months and sex and on haemoglobin genotype for all the participants. Specifically, for the participants with HbSS, information on their whether they are taking hydroxyurea (HU), and penicillin chemoprophylaxis was recorded. To assess the prevalence of dental caries, clinical examination of all primary maxillary and mandibular teeth to determine the presence or absence of dental caries lesions was also recorded.

Results

A total of 1197 teeth from 93 children were examined, whereby, 45 (2.4%) of them had dental caries. The participating children with HbAA genotype (6.6%, N=21) had more dental caries than their HbSS counterparts (2.0%, N=24), while none of the participants with HbAS exhibited dental caries. Among the participants with HbSS, males and those who use HU were 3.79 and 3.07 times more likely to have dental caries than their counterparts, female and non-users of HU, respectively.

Conclusion

Dental caries was observed to be low among participants with HbSS when compared to those with HbAA. More research utilizing more robust methodologies is recommended.

Treatment time, outcome, and anchorage loss comparisons of self-ligating and conventional brackets

OBJECTIVE

To compare the treatment time, outcome, and anchorage loss among orthodontic patients treated by self-ligating brackets (SLBs) and conventional brackets (CBs).

MATERIALS AND METHODS

A retrospective cohort study compared 34 patients (SLB group) treated by SmartClip brackets (3M Unitek, Monrovia, Calif) to 35 patients (CB group) treated by conventional preadjusted Victory series brackets (3M Unitek) and ligated by stainless steel wire ligatures. Pretreatment (T1) and posttreatment (T2) lateral cephalograms were traced and analyzed using Pancherz sagittal-occlusion analysis to obtain skeletal and dental changes in the maxilla and the mandible. The dental cast models were assessed by the Peer Assessment Rating (PAR) Index for the treatment outcomes.

RESULTS

The mean treatment time for SLBs (19.19 months) did not show a statistically significant difference from 21.25 months of CBs; the treatment time and pretreatment PAR scores were strongly correlated. There was no difference in anchorage loss between the SLB and CB groups. There were significant dental and skeletal changes among adolescent orthodontic patients regardless of the bracket used. The lingual inclination of the mandibular incisors in the CB group was 3.62° more than in the SLB group (P < .01).

CONCLUSIONS

The treatment time and anchorage loss are not influenced by the type of bracket used. There are significant dental and skeletal changes among adolescent orthodontic patients regardless of the bracket used. There is significantly greater lingual inclination of mandibular incisors in the CB group than in the SLB group.