Healthy Dental Pulp Oxygen Saturation Rates in Subjects with Homozygous Sickle Cell Anemia: A Cross-Sectional Study Nested in a Cohort

Souza, Soraia de Fátima Carvalho; Thomaz, Érika Bárbara Abreu Fonseca; Costa, Cyrene Piazera Silva

doi:10.1016/j.joen.2017.07.011

Cited by 13 publications

(52 citation statements)

References 25 publications

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“…The frequency of vaso‐occlusion, one of the three forms of sickle cell crises (SCCs) (Embury, 2004; Hebbel, 1991), during a year determines the clinical severity of SCA and can result in vital organ damage (Naoum, 2000; Jesus & Escobar, 2002). This type of crisis has been considered to be a possible explanation for the impairment of dental pulp vitality of permanent teeth with intact crowns (Dermibaş, Aktener & Unsal, 2004; Costa, Thomaz, & Souza, 2013; Souza, Thomaz, & Costa, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore in the present study, three hypotheses were tested: (a) increase in the number of sickle cell crises in the previous year (No. SCCs/year), increase frequency of episodes of vaso‐occlusion, which can results in body hypoxia as also as in pulp necrosis (Naoum, 2000; Jesus & Escobar, 2002; Costa et al, 2013), (b) low body SpO 2 in patients with HbSS can reduce of peripheral perfusion, consequently, reduce pulp blood flow irreversibly (Naoum, 2000; Jesus & Escobar, 2002; Demirbaş et al, 2004; Costa et al, 2013; Souza et al, 2017), and (c) the presence of comorbidities (CoMs) in patients with HbSS results in PN because the peripheral circulation of these patients is blocked by sickle cells, thus resulting in necrotic tissue sites and CoMs (Naoum, 2000; Jesus & Escobar, 2002; Costa et al, 2013; Souza et al, 2017). We conducted this study to analyze the effect of No.…”

Section: Introductionmentioning

confidence: 99%

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Biological factors associating pulp necrosis and sickle cell anemia

et al. 2020

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Background This study was conducted to investigate the biological factors underlying the association between pulp necrosis (PN) in subjects with permanent teeth with intact crowns and sickle cell anemia (SCA). Methods This cohort study included 140 subjects: 125 without PN and 15 with PN. A theoretical model was built to explore the following biological factors involved in the association between PN and SCA, namely (a) increased number of sickle cell crises in the previous year (No. SCCs/year), (b) low percentage of blood oxygen saturation (SpO2) in the body, and (c) comorbidities (CoMs). The theoretical model for testing associations was analyzed by structural equation modeling. Results PN was associated with CoMs (SFL = 1.115; p = .032) but not with No. SCCs/year (SFL = .127; p = .596) or body SpO2 (SFL = −.102; p = .485). The prevalence rates of osteoarticular lesions (p = .009) and death (p<.001) were significantly higher in subjects with PN than in those without. Conclusions Comorbidities, primarily osteoarticular lesions, are associated with PN in permanent teeth with intact crowns of patients with SCA. PN can be considered an indicator of the lethality of SCA.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biological factors associating pulp necrosis and sickle cell anemia

et al. 2020

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“…In the meta-analysis by tooth group, 18 studies [3,4,9,11,16-23, [25][26][27][28][29][30] were included in the central incisor group, for a total of 2,054 teeth. The mean fixed-effect measure of SpO 2 in the dental pulp of these teeth was 84.94% (95% confidence interval [CI], 84.85%-85.04%).…”

Section: Resultsmentioning

confidence: 99%

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

et al. 2020

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Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO 2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO 2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I 2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO 2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

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“…An association between SCD and pulp necrosis has been observed, where the presence of necrotic pulp in clinically healthy teeth was 8.3 times higher than in healthy patients [38]. Maxillary teeth, except the canines, with confirmed pulp vitality from SCD patients exhibit lower arterial oxygen saturation, probably as a result of vaso-occlusion due to the accumulation of sickled red blood cells in the large medullary spaces of bones [39]. The effect of SCD in the pulpal microcirculation might result in necrosis without any other etiological factor [40].…”

Section: Anemia and Oral Healthmentioning

confidence: 98%

Non-Malignant Blood Disorders and Their Impact on Oral Health: an Overview

Boström

Lira-Júnior

2019

Curr Oral Health Rep

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Purpose of Review This review aims to summarize the literature on inherited hemoglobin and coagulation disorders, focusing on sickle cell disease (SCD), thalassemia, hemophilia, and von Willebrand disease (vWD), and their impact on oral health. Clinical dental management of patients with these conditions is also reviewed. Recent Findings There is no evident association between caries and SCD. Despite limited available studies, there may be a possible association between caries and thalassemia, which could relate to salivary changes in immunoglobulin A and Streptococcus mutans reported in these patients. Controversial results on the caries experience of hemophilia and vWD patients are found in the literature, which are likely to reflect differences in the provided preventive dental care of these patients rather than a biological association. Current evidence does not support any association between periodontal disease and SCD. The literature on periodontal disease and thalassemia shows controversial results although some evidence suggests differences in the gingival inflammation of thalassemia patients with increased levels of inflammatory cytokines and matrix metalloproteinases, deserving further investigation. The available literature does not provide evidence of an increased risk for gingival bleeding or periodontal disease in patients with hemophilia or vWD. Dental management of these patients requires appropriate measures to prevent infection and excessive bleeding. The use of local hemostatic may often be sufficient; however, in severe bleeding disorders, systemic hemostatic or replacement therapy may be required, and procedures are recommended to be planned with the patient's hematologist. Summary Maintaining good oral health through preventive dentistry is important for patients with inherited hemoglobin and coagulation disorders as that may prevent the risk of infection and the need for invasive dental treatments that can result in bleeding complications. Keywords Hematologic diseases. Anemia. Blood coagulation disorders. Oral health. Periodontal diseases. Dental caries This article is part of the Topical Collection on Systemic Diseases * Elisabeth A.

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Healthy Dental Pulp Oxygen Saturation Rates in Subjects with Homozygous Sickle Cell Anemia: A Cross-Sectional Study Nested in a Cohort

Cited by 13 publications

References 25 publications

Biological factors associating pulp necrosis and sickle cell anemia

Biological factors associating pulp necrosis and sickle cell anemia

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

Non-Malignant Blood Disorders and Their Impact on Oral Health: an Overview

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