Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

Abstract

This study was conducted to investigate the relationship among radiographic features observed on panoramic radiographs of sickle cell disease patients and analyze their relationship with history of systemic severity of the disease. Panoramic radiographs of 71 subjects with sickle cell disease were evaluated for the presence of the following radiographic bony alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae and corticalization of mandibular canal. History of clinical systemic severity was assessed through direct questioning about the frequency of vaso-occlusive crisis, history of stroke, clinical jaundice, femur head necrosis, and leg ulceration. Chi-square or Fisher's exact test were applied in order to analyze possible associations between radiographic features and history of complications, with p < 0.05 significance level. Increased spacing of bony trabeculae was statistically associated with absence of corticalization of mandibular canal (p < 0.01) and horizontal arrangement of bony trabeculae (p = 0.04). Statistically significant associations were demonstrated between history of clinical jaundice and presence of increased spacing of bony trabeculae (p = 0.02) and between history of stroke and presence of horizontal arrangement of bony trabeculae (p = 0.04). Based on the results of the current study, maxillofacial radiographic features may be associated with clinical parameters of systemic complications in sickle cell disease patients. The relationship between radiographic features and history of complications associated with clinical severity of sickle cell disease has not been demonstrated in the literature. Acknowledgment of such possible association may help establish prognosis and influence clinical treatment of systemic and oral complications.

Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities

“…In evaluating 71 patients with SCA, Neves et al. () found statistically significant associations between history of clinical jaundice and increased trabecular spacing ( p = .02) and between a history of stroke and a horizontal pattern of trabecular bone ( p = .04). These findings demonstrate the importance of studies on the oral complications of the disease as predictors of systemic diseases.…”

“…SCA and SCT subjects have higher frequencies of trabecular bone changes. Some studies usually report that some radiographic features of SCA are increased radiolucency of the jaws due to the decreased number of trabeculae, coarse trabeculae pattern and step‐ladder appearance created in the interdental alveolar bone by horizontal rows of trabeculation (da Fonseca et al., ; Neves et al., ), but only two studies reported theses changes in SCT subjects (Gillis & West, ; Halstead, ). The presence of these radiographic features can be deterministic for the existence of SCA and SCT.…”

“…To date, no study has reported the association of SCA and SCT with bone and dental changes, especially using multivariate analysis. Only one article reported a correlation between clinical severity of SCA and frequency of bone changes (Neves et al., ), but this study had methodological limitations because of the small sample size and the lack of a control group. Note that the sample size in this study was calculated and had sufficient power to report statistical differences accurately among groups for many associations.…”

“…Some of the studies found were case reports (Gillis & West, ; Kelleher et al., ), literature reviews (Javed et al., ; Kelleher et al., ) and radiographic evaluations with small sample sizes (Sanger & Bystrom, ). One study found a correlation between bone changes and clinical severity of SCA (Neves et al., ), but it did not include a control group. Therefore, these study designs are not appropriate to estimate associations between exposure and outcome.…”

Detección precoz de anemia de células falciformes por medio de un diagnóstico clínico y radiográfico oral. Reporte de caso / Early Detection of Sickle Cell Anemia by oral Diagnosis and oral Radiographs. Case Report

“…En el análisis radiográfico se hallaron cambios óseos primarios en la zona interradicular de incisivos inferiores anteriores y un patrón de escalera molar inferior izquierdo con mayor notoriedad, los cuales son consistentes con lo reportado en estudios de radiografías panorámicas en pacientes con ACF (23).…”