Enamel defects and tooth eruption disturbances in children with sickle cell anemia

Abstract Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Caries prevalence and socioeconomic factors in children with sickle cell anemia

The aim of the present study was to investigate caries prevalence and socioeconomic factors in children with sickle cell anemia. This study was conducted in 160 children with sickle cell anemia aged 3 to 12 years attending the Center for Hematology in Recife, Brazil . Data collection included interviews with guardians concerning social factors and oral examinations to determine the caries prevalence. Statistical analyses were performed using the Kruskal-Wallis and Pearson's chi-square tests at a 5% significance level. The caries prevalence was 55.0%. The dmft index was 2.12, and the DMFT index was 1.50. Income significantly influenced dmft; the mean dmft was 4.57 in children whose family income was less than the Brazilian minimum wage (BMW), whereas in children with a family income three times the BMW or higher, the mean dmft was 2.27. No statistically positive association was found between the educational level of parents and guardians and the caries indices. A statistically significant association was found between dental caries prevalence and family income.

Prevalência de sangramento gengival na sondagem periodontal de pacientes hemofílicos: um estudo série de casos / Prevalence of bleed gengival in sounding periodontal of hemophilic patients: a series case study

Com o intuito de estudar a presença ou não de sangramento gengival em pacientes hemofílicos foi realizada uma pesquisa em 10 pacientes portadores da hemofilia regularmente registrados no ambulatório do HEMOPE (Hemocentro de Pernambuco), do sexo masculino, através da sondagem preconizada pelo NIDR (National Institute of Dental Research) realizada com uma sonda do NIDR, e constatou-se que 9(90 por cento) dos pacientes estudados apresentaram sangramento à sondagem periodontal, enquanto 1 (10 por cento)paciente não apresentou sangramento em nenhum dos sítios estudados; 90 por cento dos pacientes eram hemofílicos do tipo A, enquanto 10 por cento era hemofílico do tipo B, confirmando os estudos que indicaram a hemofilia A como a coagulopatologia de maior frequência entre as duas. Quanto ao grau de severidade, 60 por cento dos hemofílicos eram do tipo moderado, 30 por cento do tipo leve e 10 por cento do tipo severo. Em relação à faixa etária 30 por cento dos pacientes tinham dez anos, 50 por cento tinham de 11 a 20 anos e 20 por cento tinham mais de 20 anos, constatando uma maior longevidade destes pacientes. Com relação à presença de placa visível, 70 por cento dos hemofílicos apresentaram placa e 30 por cento não apresentaram, segundo o número de escovações diárias foi de uma vez ao dia para 30 por cento dos pacientes, duas vezes ao dia também 30 por cento e três vezes ao dia em 40 por cento dos hemofílicos. O estudo concluiu que este sangramento está associado à presença de placa bacteriana, e não à patologia, pois a doença hemofilia, por si só, não traz problemas dentários e periodontais de forma direta.