Mandibular lesions of vasoocclusive origin in sickle cell hemoglobinopathy

Kavadia-Tsatala, Smaragda; Kolokytha, Olga; Kaklamanos, Eleftherios G.; Antoniades, K.; Chasapopoulou, Eleni

doi:10.1007/s10266-004-0036-3

Cited by 30 publications

(39 citation statements)

References 24 publications

(50 reference statements)

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“…Radiopacities in the bone are reported in SCD patients, occurring more commonly in posterior mandible along vascular canals or apical region of teeth, and reflect a previous history of bone infarcts [21]. During generalized sickle cell crises, vaso-occlusive involvement of mandible of ischemic and aseptic nature can occur, displaying odontogenic pain or neuropathy [17,29] and contributing for dental pulp death [36]. Literature reports few cases of mandibular infarction [14,15,17,37], probably due to significant collateral circulation and difficulty in documenting infarction in this bone [9].…”

Section: Discussionmentioning

confidence: 98%

“…The radiographic parameters evaluated were based on previously reported features commonly associated with SCD [28,29] and β-thalassaemia major [31], categorized as follows:…”

Section: Methodsmentioning

confidence: 99%

“…Few studies have analyzed their prevalence among SCD patient and healthy controls [23][24][25][26][27][28][29][30]. However, to the best of our knowledge, relationship between the presence of radiographic features and history of complications associated with clinical severity of SCD has not been demonstrated.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

et al. 2011

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This study was conducted to investigate the relationship among radiographic features observed on panoramic radiographs of sickle cell disease patients and analyze their relationship with history of systemic severity of the disease. Panoramic radiographs of 71 subjects with sickle cell disease were evaluated for the presence of the following radiographic bony alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae and corticalization of mandibular canal. History of clinical systemic severity was assessed through direct questioning about the frequency of vaso-occlusive crisis, history of stroke, clinical jaundice, femur head necrosis, and leg ulceration. Chi-square or Fisher's exact test were applied in order to analyze possible associations between radiographic features and history of complications, with p < 0.05 significance level. Increased spacing of bony trabeculae was statistically associated with absence of corticalization of mandibular canal (p < 0.01) and horizontal arrangement of bony trabeculae (p = 0.04). Statistically significant associations were demonstrated between history of clinical jaundice and presence of increased spacing of bony trabeculae (p = 0.02) and between history of stroke and presence of horizontal arrangement of bony trabeculae (p = 0.04). Based on the results of the current study, maxillofacial radiographic features may be associated with clinical parameters of systemic complications in sickle cell disease patients. The relationship between radiographic features and history of complications associated with clinical severity of sickle cell disease has not been demonstrated in the literature. Acknowledgment of such possible association may help establish prognosis and influence clinical treatment of systemic and oral complications.

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Section: Discussionmentioning

confidence: 98%

“…The radiographic parameters evaluated were based on previously reported features commonly associated with SCD [28,29] and β-thalassaemia major [31], categorized as follows:…”

Section: Methodsmentioning

confidence: 99%

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Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

et al. 2011

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“…Oral problems, including unilateral infarct of the mandible [59,60], pulpal necrosis [59,61], osteonecrosis [62], facial swelling [63], diastema and hypodontia [64], gingival enlargement [63], palatal pallor [65], increased risk for caries [66], osteomyelitis of the mandible [67], unilateral anesthesia [60,62], midfacial overgrowth [65], and orofacial pain [65,67,68], have been reported [69]. As iNOS activity and expression are strongly correlated with immune and inflammatory systems, to eliminate the likelihood of conflicting results in the present study only participants that were free of clinically detectable infection and inflammation were included; the participants had no ongoing dental, periodontal, or orofacial disorders.…”

Section: Discussionmentioning

confidence: 99%

Nitric oxide in gingival crevicular fluid and nitric oxide synthase expression in the gingiva of patients with sickle cell disease

Güzeldemir

Toygar²,

Bal³

et al. 2011

Turk J Hematol

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Objective: This study aimed to biochemically measure the production of nitric oxide in gingival crevicular fluid and immunohistochemically measure the expression of inducible nitric oxide synthase in the gingiva of patients with sickle cell disease. Additionally, we aimed to obtain insight into the immunopathology of sickle cell disease by comparing inducible nitric oxide synthase levels in patients with sickle cell disease and controls using gingiva and gingival crevicular fluid. Materials and Methods: The study included 20 sickle cell disease patients and 20 healthy controls. Immunohistochemical analysis was used to measure inducible nitric oxide synthase expression in gingiva and nitric oxide levels in gingival crevicular fluid were spectrophotometrically measured. Results: Nitric oxide levels in the patients and controls did not differ significantly (21.2±4.5 and 23.1±2.3 μM L -1 , respectively, p>0.05). There weren't any statistically significant differences in infiltrated inflammatory cells, density of inflammatory cells that stained with inducible nitric oxide synthase, or nitric oxide expression in gingiva between the patient and control groups (p>0.05). Conclusion: To the best of our knowledge this is the first study to examine the expression of inducible nitric oxide synthase in the gingiva and gingival crevicular fluid in patients with sickle cell disease. Using the gingiva and gingival crevicular fluid we were unable to observe sickle cell disease-associated inducible nitric oxide synthase expression and a difference in nitric oxide levels.

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“…3 In the oral cavity, SCA can cause diastemata, delays in tooth eruption, 5,6,7 malocclusion and glossitis. 6,7,8,9 There are no studies in the literature containing conclusive data related to the prevalence of caries and periodontal disease in children afflicted by SCA, 10,11 despite the existence of biological plausibility for an association between incidence of caries and severity of the disease.…”

Section: Introductionmentioning

confidence: 99%

Maternal risk behavior and caries incidence in children with sickle cell disease

et al. 2016

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The aim of this study was to analyze the incidence of caries, in relation to maternal risk behaviors and clinical conditions representing different levels of sickle cell disease severity. A total of 295 children aged 6 to 60 months participated in this cohort conducted from August 2007 to December 2008. They were diagnosed and monitored by the referral service of the state. Interviews were made with families to identify sociodemographic variables, and an oral exam was performed to determine dental caries. The SRQ (Self Report Questionnaire) scale was used to diagnose the presence of common mental disorders, and the CAGE (Cut down, Annoyed, Guilty and Eye opener) was applied to determine abusive use of alcohol. The absolute and relative frequencies of the variables of interest were analyzed by Chi-square and Mann-Whitney, with a 5% significance level. The incidence variables were analyzed according to the logistic regression model, with a confidence interval of 95%. Caries incidence (1.98; SD = 4.68) was higher in the HbSS genotype. There was a statistically significant association between caries incidence and both abusive use of alcohol (32.43%, RR = 1.99; 1.05-3.78; 95%CI) and common mental disorders (8.77% RR = 0.37; 0.15-0.93; 95%CI). There was also an association between caries incidence and maternal risk behavior, indicating that the care network should be expanded to include patients with sickle cell disease.

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Mandibular lesions of vasoocclusive origin in sickle cell hemoglobinopathy

Cited by 30 publications

References 24 publications

Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

Nitric oxide in gingival crevicular fluid and nitric oxide synthase expression in the gingiva of patients with sickle cell disease

Maternal risk behavior and caries incidence in children with sickle cell disease

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