Dental enamel development defects in children and adolescents with HIV infection: case‐control study

Pontes, Alessandra Silva; Lima, Marina de Deus Moura de; Andrade, Natália Silva; Moura, Marcoeli Silva de; Moura, Lúcia de Fátima Almeida de Deus

doi:10.1111/scd.12188

Cited by 3 publications

(8 citation statements)

References 37 publications

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“…Medicals complications ( 11 ) or toxemia during pregnancy ( 12 ) are related to DDE. More specifically: ZIKV ( 13 , 14 ), rubella embryopathy ( 15 ), deficiencies of vitamin D ( 16 – 18 ), low calcemia ( 16 , 19 ), increased maternal weight gain and failure to access to antenatal care ( 20 ), urinary tract infection ( 21 ), gestational diabetes ( 16 , 22 , 23 ), bleeding ( 24 ), frequent vomiting ( 25 ), maternal psychological stress ( 26 ), hypotension-related anemia ( 26 ), hypertension ( 27 ), and frequent exposure to ultrasonic scans during the last gestational trimester ( 26 ). Maternal consumption of Tynelol during pregnancy ( 20 ), antibiotic ( 28 ) prenatal anti-epileptic drugs ( 29 ), tocolytic agent ( 30 ), alcohol ( 31 , 32 ), tea ( 20 ), tobacco use ( 25 , 33 ) were associated to DDE.…”

Section: Methodsmentioning

confidence: 99%

“…Early-life events ( 49 ), medical condition ( 26 ), severe diseases during the period 0–3 years ( 58 ), and high frequency of pediatric disease ( 21 ) appear to be associated with aDDE. This may involve serious/chronic childhood diseases ( 11 , 14 , 59 ), such as the following factors cited in the literature: vitamin D deficiencies ( 17 ), hypocalcemia ( 60 ), chicken pox ( 61 ), infectious episodes ( 38 , 53 ), high fever ( 6 , 62 ), hospital admission ( 40 ), ear infection ( 27 , 63 ), renal disorders ( 64 ), liver failure/ liver transplant ( 65 ), thyroid dysfunction (both hypothyroidism and hyperthyroidism) ( 66 ), infantile eczema ( 33 ), tonsillectomy ( 67 ), intestinal disturbance [parasitic helminth infection ( 68 ) and pyloric spasm ( 63 ), celiac disease ( 69 , 70 ), vomiting and diarrhea ( 61 )], electric burns ( 71 ), idiopathic epilepsy ( 72 ), and the use of some drugs: antiretroviral therapy ( 24 ), antibiotic use ( 6 , 14 , 33 , 73 ), specifically penicillins ( 74 , 75 ) and cephalosporins ( 76 ).…”

Section: Methodsmentioning

confidence: 99%

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Factors and Mechanisms Involved in Acquired Developmental Defects of Enamel: A Scoping Review

et al. 2022

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BackgroundDevelopmental Defects of Enamel (DDE) is a pathology of the teeth that can greatly alter the quality of life of patients (hypersensitivity, esthetic issues, loss of function, etc.). The acquired DDE may occur as a result of a wide range of acquired etiological factors and his prevalence of this pathology may reach up to 89.9%. The main objective of this research was to identify and analyze, in current literature, the factors related to acquired DDE, in order to propose a general theory about the mechanisms involved.MethodsThe search of the primary literature was conducted until [December 31, 2021]. Our search strategy uses the Pubmed/MEDLINE database and was structured around 3 terms [“Development,” “Defect,” and “Enamel”]. To be included, references had to be primary studies, written in English. Exclusion criteria were reviews, in vitro, animal, genetic or archeology studies, and studies focused on clinical management of DDE. One hundred and twenty three articles were included in this scoping review: 4 Randomized clinical trials, 1 letter, 5 cases reports, 2 fundamentals studies, and 111 observational studies (33 Cross-sectional studies, 68 Cohort study and 10 Case-control study). The quality of evidence was assessed using the PEDro scale for clinical trials, the Newcastle-Ottawa scale for observational studies, and a published tool to assess the quality of case reports and case series.ResultsA scoping review of the literature identified 114 factors potentially involved in acquired DDE. The most frequently encountered pathologies are those causing a disorder of calcium homeostasis or a perturbation of the ARNT pathway in mother or child. The link between the ARNT pathway and metabolism deficiency in uncertain and needs to be defined. Also, the implication of this mechanism in tissue impairment is still unclear and needs to be explored.ConclusionsBy identifying and grouping the risk factors cited in the literature, this taxonomy and the hypotheses related to the mechanism allow health practitioners to adopt behaviors that limit the risk of developing aDDE and to set up a prevention of dental pathology. In addition, by reviewing the current literature, this work provides guidance for basic research, clinical studies, and literature searches.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Factors and Mechanisms Involved in Acquired Developmental Defects of Enamel: A Scoping Review

et al. 2022

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“…In particular, HIV infection can lead to several systemic implications, including impairments in immune function in children, and can affect the development of dental enamel [ 10 ]. Similarly, the number of CD4 cells, an HIV categorizing marker, has been linked to the incidence and presentation of oral manifestations.…”

Section: Introductionmentioning

confidence: 99%

“…With prevention of mother to child transmission (PMTCT) programs, treatment with antiretroviral therapy (ART) is often administered at an early age in children of HIV-infected mothers to control the infection. Despite being effective, ART might disrupt osteogenesis [ 11 ] and lead to DDEs in permanent dentition [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of enamel developmental defects among Nigerian children with perinatal HIV exposure

Onyia

Akhigbe

Osagie

et al. 2023

Journal of Clinical Pediatric Dentistry

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To evaluate the prevalence and pattern of developmental defects of the enamel (DDE) and their risk factors among children born infected with Human Immunodeficiency Virus (HIV) and those born to HIV-infected mothers compared with their unexposed counterparts (i.e., children born to uninfected mothers). This was an analytic cross-sectional study evaluating the presence and pattern of distribution of DDE in three groups of school-aged children (age, 4–11 years) receiving care and treatment at a Nigerian tertiary hospital, comprising: (1) HIV-infected (HI) on antiretroviral therapy (ART)(n = 184), (2) HIV-exposed but uninfected (HEU) (n = 186) and (3) HIV-unexposed and uninfected (HUU) (n = 184). Data capture forms and questionnaires were used to record the children’s medical and dental history based on clinical chart review and recall from their parents/guardians. Dental examinations were performed by calibrated dentists blinded to the study grouping. CD4+ (Cluster of Differentiation) T-cell counts were assayed for all participants. The diagnosis of DDE corresponded with the codes enumerated in the World Dental Federation’s modified DDE Index. Analyses relied on comparative statistics to determine risk factors associated with DDE. A total of 103 participants distributed among the three groups presented with at least one form of DDE, which indicated a prevalence of 18.59%. The HI group had the highest frequency of DDE-affected teeth (4.36%), while that of the HEU and HUU groups were 2.73%and 2.05%, respectively. Overall, the most encountered DDE was code 1 (Demarcated Opacity), accounting for 30.93% of all codes. DDE codes 1, 4 and 6 showed significant associations with the HI and HEU groups in both dentitions (p < 0.05). We found no significant association DDE and either very low birth weight or preterm births. A marginal association with CD4+ lymphocyte count was observed in HI participants. DDE is prevalent in school-aged children, and HIV infection is a significant risk factor for hypoplasia, a common form of DDE. Our results were consistent with other research linking controlled HIV (with ART) to oral diseases and reinforce advocacies for public policies targeted at infants exposed/infected perinatally with HIV.

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“…Salivary gland disease results in a dramatic reduction of salivary flow, leading to significant morbidity in CALHIV ( Walsh 2007 ; Gennaro et al 2008 ; Ramos-Gomez and Folayan 2013 ). ART-associated enamel hypoplasia is common in the permanent dentition of CALHIV, possibly linked to protease inhibitors or efavirenz ( Pontes et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Oral Diseases and Oral Health–Related Quality of Life among Kenyan Children and Adolescents with HIV

Wang

Ramos‐Gomez

Kemoli

et al. 2022

JDR Clinical & Translational Research

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Introduction: Children and adolescents living with HIV (CALHIV) have a higher risk of hard and soft oral tissue diseases as compared with their healthy peers. It is important to increase awareness regarding the need to integrate oral health within medical care among pediatric HIV populations. Studies on associations of oral diseases with oral health–related quality of life (OHRQoL) in CALHIV are lacking. This study examined the association between oral diseases and OHRQoL in Kenyan CALHIV. Methods: This cross-sectional analysis was nested in a longitudinal cohort study of CALHIV in Nairobi. CALHIV received oral examinations, and the World Health Organization’s Oral Health Surveys and Record Form was administered. OHRQoL was measured with the Parental-Caregiver Perceptions Questionnaire, with the subdomains of global, oral symptoms, function limitations, and emotional and social well-being, with higher scores indicating poorer OHRQoL. Linear regression was used to model associations between OHRQoL and oral diseases, adjusting for age at the time of oral examination, CD4 counts, and caregiver’s education. Results: Among 71 CALHIV, the mean age was 12.6 y (SD, 2.9; range, 10 to <21), and the mean composite OHRQoL score was 12.6 (SD, 11.2). Ulcers (not herpes simplex virus or aphthous) were associated with the worst overall OHRQoL (mean, 21.8; SD, 11.1; P = 0.055) and oral symptoms subdomain (mean, 7.0, SD, 2.5; P = 0.003). Children with dry mouth and untreated caries had significantly higher mean global OHRQoL scores than those without disease (P < 0.0001). In the multivariate analysis, the OHRQoL composite score was 6.3 units (95% CI, –0.3 to 12.9) higher for those who had dry mouth and untreated dental caries; dry mouth accounted for the highest percentage of variability of OHRQoL (9.6%) and the global subdomain (31.9%). Ulcers accounted for the highest percentage of variability of the oral symptoms domain (15.4%). Conclusions: Oral ulcers, dry mouth, and untreated caries were associated with poorer OHRQoL in CALHIV. Integrating oral health into the primary care of CALHIV may improve their OHRQoL. Knowledge Transfer Statement: This study aimed to determine the association of oral diseases with the oral health–related quality of life of children and adolescents living with HIV (CALHIV). The findings will form part of the evidence to incorporate oral health protocols into care programs for CALHIV. Oral health monitoring has the potential to increase the surveillance of HIV clinical status, monitor the effectiveness of antiretroviral therapy, and improve the oral health–related quality of life of CALHIV.

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Dental enamel development defects in children and adolescents with HIV infection: case‐control study

Cited by 3 publications

References 37 publications

Factors and Mechanisms Involved in Acquired Developmental Defects of Enamel: A Scoping Review

Factors and Mechanisms Involved in Acquired Developmental Defects of Enamel: A Scoping Review

Prevalence and associated factors of enamel developmental defects among Nigerian children with perinatal HIV exposure

Oral Diseases and Oral Health–Related Quality of Life among Kenyan Children and Adolescents with HIV

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