Enamel defects and tooth eruption disturbances in children with sickle cell anemia

Abstract

Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Association between sickle cell disease and dental caries: a systematic review and meta-analysis

“…commonly reported hypomineralization of enamel, diminished oral hygiene, and low salivary flow rate, and drug treatments containing sugar were found in SCD patients [17,37], suggesting that the association of risk factors may lead to susceptibility to dental caries in these affected individuals. However, in this systematic review, no statistically significant differences were found in the scores of dental caries between SCD patients and the non-SCD group as measured by the mean DMFT and DMFS indexes.…”

Manifestações orofaciais de anemias: características para uma abordagem odontológica

“…Tal pesquisa apresentou o resultado de 58,2% da amostra com algum defeito de esmalte e 32,1 % com erupção dentária tardia. (Lopes et al, 2018).…”

Manifestações orofaciais associadas aos diferentes tipos de anemias

“…A anemia falciforme é um distúrbio causado pela produção anormal da HbS, em que há a substituição da valina pelo ácido glutâmico na sexta posição da extremidade do terminal NH2 da cadeia da β-globina, este distúrbio afeta pelo menos 5,2% da população global 21 . Com a diminuição da tensão de oxigênio, a Hb anormal se polimeriza, formando polímeros fluidos (tactoides) que fazem com que os glóbulos vermelhos se modifiquem para uma forma de foice, obstruindo diferentes áreas da microcirculação 2,3 .…”

“…Embora relativamente incomum, uma série de alterações orofaciais também foram observadas na doença falciforme 1,2,14,21,22 . Quando ocorre, a patogenicidade básica é semelhante à de outros órgãos.…”

“…Quando ocorre, a patogenicidade básica é semelhante à de outros órgãos. Essas alterações orofaciais na HbS incluem crescimento excessivo da face medial atribuível à hiperplasia da medula óssea, outras alterações no crânio e na mandíbula, como aumento do espessamento do crânio, alterações osteoporóticas e infarto mandibular -o qual pode ser seguido por osteosclerose, osteomielite da mandíbula, parestesia do nervo mental, dor orofacial, hipomineralização do esmalte e diastema 2,21 . Essas deformidades dentofaciais são radiograficamente caracterizadas por uma aparência em escada do osso alveolar e áreas de densidades diminuídas e padrão trabecular grosseiro, mais facilmente visto entre os ápices radiculares dos dentes e a borda inferior da mandíbula 2,22,23 (Tabela 1).…”