Craniofacial features of patients with sickle cell anemia and sickle cell trait

Pithon, Matheus Melo; Palmeira, Láiza Michele Vieira; Barbosa, Ana Angélica Leal; Pereira, Rafael; Andrade, Ana Carolina Dias Viana de; Coqueiro, Raildo da Silva

doi:10.2319/101513-764.1

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…Higher ANB angle is associated with maxillary projection among SCD patients. This corroborates with the results of Pithon et al .,[23] who observed increased ANB angle in SCD patients. Collectively, this suggests that in SCD patients, there is a tendency toward Class II malocclusion.…”

Section: Discussionsupporting

confidence: 93%

Malocclusion and craniofacial characteristics in Saudi adolescents with sickle cell disease

Basyouni

Almasoud

Al‐Khalifa

et al. 2018

Saudi J Med Med Sci

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Background:Sickle cell disease can result in dentofacial abnormalities. However, in Saudi Arabia, there are limited data with respect to orthodontic manifestations in patients with sickle cell disease.Objective:To determine the malocclusion and craniofacial characteristics in sickle cell disease adolescents and compare them with that of controls from the Eastern Province of Saudi Arabia.Methods:This comparative cross-sectional study included 112 Saudi patients with sickle cell disease, aged 12–18 years, and 124 age-matched Saudi controls from three major hospitals in Al Khobar and Dammam, Saudi Arabia. The Dental Aesthetic Index was used to assess malocclusion and orthodontic treatment needs. Digital lateral cephalometric radiographs were recorded for each patient and control, and its analysis included linear and angular measurements.Results:The prevalence of malocclusion was 87.5% in sickle cell disease patients and 54% in controls (P = 0.0001). The percentage of sickle cell disease patients with severe malocclusion that required orthodontic treatment was higher than that of controls (37.5% vs. 26.6%). In the sickle cell disease cohort, incisal segment crowding (72.4%), overjet (67.3%) and maxillary misalignment in the anterior segment (56%) were the most prevalent types of malocclusions and were significantly higher than that of controls (P < 0.05). About 38% and 67% of the sickle cell disease patients had openbite and posterior crossbite, respectively, compared with 19.3% (P = 0.001) and 37.1% (P = 0.0001) of controls, respectively. Cephalometric analysis showed that SNA (86.7°) and ANB (9.9°) angles were significantly higher in sickle cell disease patients than in controls (81.5° and 2°, respectively). In addition, lower central incisor-to-Frankfort horizontal plane (55°) and interincisal angles (121.5°) were significantly lower in sickle cell disease patients than in controls.Conclusion:Adolescents with sickle cell disease had a higher prevalence of malocclusion and greater orthodontic treatment needs than controls. Similarly, they had greater incisal crowding, overjet, openbite and posterior crossbite and demonstrated higher SNA, ANB and lower interincisal angles than controls. The findings of this study suggest that adolescents with sickle cell disease should be provided frequent dental examinations and early orthodontic treatment to improve their oral health, and thus quality of life.

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Section: Discussionsupporting

confidence: 93%

Malocclusion and craniofacial characteristics in Saudi adolescents with sickle cell disease

Basyouni

Almasoud

Al‐Khalifa

et al. 2018

Saudi J Med Med Sci

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“…The SCT group had a similar but statistically different pattern. Pithon et al 10 obtained similar findings for the maxillary prognathism and mandibular setback between the SCA and SCT patients, when compared to the control group. This finding is in line with the study conducted by Licciardello, Bertuna, Samperi, 23 which assessed the craniofacial morphology of 36 patients with sickle cell disease and 36 volunteers without the disease, aged 18.5–51 years, in which the upper incisors were significantly more buccally positioned.…”

Section: Discussionmentioning

confidence: 60%

“…The evaluation of the differences in shape and size among SCA and SCT patients and unaffected individuals allowed for the establishment of distinctions among, and the characterization of, the groups. A study undertaken by Pithon et al, 10 with the aim of categorizing the same groups using traditional morphometrics, demonstrated no significant differences between unaffected individuals and SCT patients or between unaffected individuals and SCA patients, also showing that the SCA and SCT patients exhibited the class II skeletal pattern due to the mandibular setback. Moreover, maxillary expansion was not detected by traditional morphometrics, which is at odds with the geometric morphometrics findings.…”

Section: Discussionmentioning

confidence: 99%

“…One of the available methods for assessing the effect of SCA and verifying facial changes is anthropometry, which was used by Pithon et al 10 However, another method, known as geometric morphometrics, was developed in the 1980s and widely employed in the early 1990s, yielding robust analyses and making use of graphic tools. 11 This method gathers and provides more information on morphology in a more efficient way than does the conventional technique.…”

Section: Introductionmentioning

confidence: 99%

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Craniofacial geometric morphometrics in the identification of patients with sickle cell anemia and sickle cell trait

Ferreira

Nunes

Pithon

et al. 2020

Hematology, Transfusion and Cell Therapy

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Objective The aims of this study were to identify the main characteristics regarding the shape and size of the craniofacial region in patients with sickle cell anemia (SCA) and sickle cell trait (SCT) and in unaffected patients using geometric morphometrics and to check the efficiency of this method. Material and Methods A cross-sectional analytical study of 45 patients (15 in each group) was performed. Lateral radiographs of the skull were used for the analysis. Seventeen landmarks and semilandmarks were placed for the measurements. The Pocrustes analysis of variance (ANOVA), regression analysis, multivariate analysis of variance, canonical variate analysis, Mahalanobis and Procrustes distances and unweighted pair group method with arithmetic mean (UPGMA) clustering were performed. Allometric effects and sex characteristics were not statistically significant ( p > 0.05). Results There were, however, significant differences ( p < 0.05) in craniofacial shape among SCA, SCT and unaffected individuals. Those with SCA showed variations in the shape of the external auditory meatus and at the base of the occipital bone, in addition to the mandibular setback and upper incisor inclination, with a tendency towards prognathism. The individuals with SCT exhibited a similar craniofacial shape to those with SCA, but with slighter variations. Moreover, those with SCT were statistically closer in resemblance to unaffected individuals, given that SCT is not regarded as a disease. Conclusion This demonstrates the efficiency of geometric morphometrics in the categorization of the assessed groups.

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“…Several recent studies assessed the craniofacial and occlusal features in children and adolescents with SCD [60]- [66]. Increased maxillary overjet [38], [60], [62], [64]- [66], increased overbite [38], [65], higher prevalence of openbite [60], [62], [66], greater posterior crossbite [66], burdened incisal segment crowding [66], maxillary misalignment in the anterior segment [62], [66], significant retruded mandible [60], higher prevalence of Class II molar relation [60], [62], [64], [65] and of maxillary protrusion [65]- [67] have been reported in children and adolescents with SCD than in healthy controls. As per the Dental Aesthetic Index (DAI), children and adolescents with SCD were found to have severe, handicapping malocclusion with compulsory treatment needs [60], [62], [66].…”

Section: F Malocclusion-facial Overgrowthmentioning

confidence: 99%

Sickle Cell Disease: An Overview of Oral Health Considerations for Pediatric Patients

Eleftherou

Arhakis

Davidopoulou

2021

EJDENT

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Aim: This literature review aims to update the evidence for orofacial manifestations and current treatment recommendations for children and adolescents with sickle cell disease. Background: Sickle cell disease is a frequent hemoglobinopathy and a life-threatening genetic disorder. The lifelong condition is characterized by chronic hemolytic anemia and vaso-occlusive crisis that may occur in a variable range of clinical presentations in different regions of the body, including the oral cavity. Review results: This review explored the most common orofacial alterations of pediatric patients with SCD. Dental caries is a common finding in SCD pediatric patients, especially in those who are socio-economically vulnerable. Moreover, malocclusions occur in high prevalence in SCD pediatric patients. Other oral health complications seen in SCD patients include periodontal inflammation, bone changes, infections, mental nerve neuropathy, facial overgrowth, delayed tooth eruption, dental anomalies, pulp necrosis, soft tissue alterations and salivary changes. Dental infections may trigger a vaso-occlusive crisis leading the patient to a higher probability on arriving in hospital emergency departments and in need for further hospital admission to deal with the correlated complications. Thus, preventive dental care and non-invasive dental procedures are the principal focus in SCD patients in order to avoid possible subsequent complications. Conclusion: The review showed that in pediatric patients with SCD the risk for orofacial manifestations and complications depends not only on the presence of SCD but also on other confounding factors such as oral hygiene, diet habits and social conditions. Moreover, more well-designed epidemiological studies are necessary to assess the real link between SCD disease and its impact on stomatognathic health.

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Craniofacial features of patients with sickle cell anemia and sickle cell trait

Cited by 8 publications

References 14 publications

Malocclusion and craniofacial characteristics in Saudi adolescents with sickle cell disease

Malocclusion and craniofacial characteristics in Saudi adolescents with sickle cell disease

Craniofacial geometric morphometrics in the identification of patients with sickle cell anemia and sickle cell trait

Sickle Cell Disease: An Overview of Oral Health Considerations for Pediatric Patients

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