Radiographic changes of the jaws in HbSS and HbSC genotypes of sickle cell disease

Abstract

This study used panoramic radiographs to evaluate the presence of radiographic changes in the jaws of a population who had sickle cell disease (SCD). The authors compared the frequency of findings between subjects with and without SCD. Panoramic radiographs of 71 subjects with SCD (36 with HbSS and 35 with HbSC) and 52 healthy controls (HbAA) were evaluated for the presence of the following radiographic alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae, and absence of mandibular canal corticalization. The control group had a significantly smaller number of all the radiographic features evaluated. Differences were not statistically significant between the groups with HbSS and HbSC, except for more trabecular spacing in the molar region in the HbSS genotype, suggesting a possible correlation between radiographic findings and disease presentation.

Evaluation of mandibular bone structure in sickle cell anaemia patients

“…These features have been indicated in several reports in literature. According to these reports whole body bones included mandible are affected by low density (23,(34)(35)(36). As we presented at Table I, our results were compatible with this feature.…”

“…Sickle cell anaemia is a common inherited autosomal disease which is characterized by abnormally shaped red blood cells. However it can involve virtually any organ system (23,24), but bone involvement is the most common clinical manifestation of SCA (3,25). On the other hand, although bone involvement is the most common manifestation, it is rare in the maxillofacial bone and skull base because of the small amount of marrow.…”

“…These are non-specific findings that may be also seen in thalassemia major, hereditary spherocytosis, and iron deficiency (7)(8)(9)(10)(11)(12). Although there are several reports (2)(3)(4)(5)(23)(24)(25)(26)(27)(28)(29) which have been published evaluating the clinical and radiographic alterations in the oral and maxillofacial region, to the best of our knowledge, the differences in the radiographic changes of the jawbones of SCA have not been previously described by using CBCT.…”

Prevalence of orofacial alterations in sickle cell disease: a review of literature

“…Significant increase of intertrabecular spacing in both jaws and reduction of trabecular complexity were noted in SCA individuals. Demirbas et al 34 Neves et al 35 (2011) used panoramic radiograph to evaluate the radiographic features in the oral and maxillofacial region in Brazilian patients with SCD and healthy subjects. The healthy group showed a significantly smaller number of radiographic alterations when compared to the SCD patients.…”

Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities

“…Dental changes, such as pulp calcification and hypercementosis, have been reported and observed on radiographic images (Bishop, Briggs, & Kelleher, ; Soni, ; Taylor, Nowak, Giller, & Casamassimo, ). Another change in SCA that can be verified radiographically is the decrease in maxillary and mandibular bone radiodensities and the formation of a coarse trabecular pattern described as “ladder shaped” (Neves et al., ). This change is attributed to erythroblastic hyperplasia resulting from the vaso‐occlusive phenomenon and compensatory bone expansion (Costa, de Carvalho, Thomaz, & Sousa Sde, ).…”