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

Abstract

Objective: To identify the craniofacial characteristics of patients with sickle cell trait (SCT) and sickle cell anemia (SCA) and to compare these measurements with those of nonaffected subjects. Materials and Methods: Clinically normal patients and those with SCT and SCA were evaluated in this study. The patients were divided into three groups: normal (control), SCA, and SCT (n 5 with 15 in each group). Inclusion criteria were SCA or SCT verified by laboratory methods and no treatment with fixed orthodontics or facial orthopedics. Lateral cephalometric radiographs were carried out and were used to obtain angular and linear measurements of anatomic structures displayed. All markings and measurements were performed by a single examiner. Results: The average ANB was increased in groups with SCA (5.47 6 2.0u) and SCT (3.80 6 1.4u), indicating a tendency to Class II. The mean SNA angle was 83.0 6 3.8u and 82.163.5u for SCA and SCT, indicating a proper positioning of the jaw from the skull base. There was an interaction between the group and sex factors for the variable SN-GoGn; measures were higher for men in the SCA group. Conclusion: Patients with SCA and SCT exhibited characteristics of Class II skeletal pattern because of mandibular retrusion. Most patients showed no compensatory maxillary expansion, which was determined by the normal jaw length and absence of maxillary protrusion. (Angle Orthod. 2014;84:825-829.)

Malocclusion and craniofacial characteristics in Saudi adolescents with sickle cell disease

“…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.…”

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

“…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.…”

“…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.…”

“…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.…”

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

“…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].…”