Are dental and jaw changes more prevalent in a Brazilian population with sickle cell anemia?

OBJECTIVE: The aim of this study was to analyze the prevalence of dental and jaw changes in individuals with sickle cell anemia (SCA) compared with a control group from a Brazilian population. STUDY DESIGN: This was a retrospective cross-sectional study. Participants were divided into 2 groups: SCA and control (123 patients per group). Intraoral periapical radiographs were taken. Changes in bone pattern and dental changes were investigated by using the following radiographic parameters: (1) trabecular bone (step-ladder or spider web); (2) integrity of the lamina dura (loss of sharpness and continuity, partial or complete absence, and increased thickness); and (3) dental changes (pulp chamber, root surface, periapex, dental form, number, and position). Fisher's exact and χ2 tests were used to compare frequencies and the Mann-Whitney test was used to compare medians (P < .05). RESULTS: Step-ladder (P < .001) and spider-web patterns (P < .001) in trabecular bone of the jaw were more common in individuals with SCA than in the control group. Loss of lamina dura was more frequent in those with SCA than in control individuals (P = .021). Dental changes were not different between groups (P > .05), even though the prevalence of hypotaurodontism was twice as high in the SCA group as in controls (P = .086). CONCLUSIONS: The prevalence of jaw changes is higher in individuals with SCA.

Craniofacial bone abnormalities and malocclusion in individuals with sickle cell anemia: a critical review of the literature.

This study aims to critically review the literature in respect to craniofacial bone abnormalities and malocclusion in sickle cell anemia individuals. The Bireme and Pubmed electronic databases were searched using the following keywords: malocclusion, maxillofacial abnormalities, and Angle Class I, Class II and lass III malocclusions combined with sickle cell anemia. The search was limited to publications in English, Spanish or Portuguese with review articles and clinical cases being excluded from this study. Ten scientific publications were identified, of which three were not included as they were review articles. There was a consistent observation of orthodontic and orthopedic variations associated with sickle cell anemia, especially maxillary protrusions. However, convenience sampling, sometimes without any control group, and the lack of estimates of association and hypotheses testing undermined the possibility of causal inferences. It was concluded that despite the high frequency of craniofacial bone abnormalities and malocclusion among patients with sickle cell anemia, there is insufficient scientific proof that this disease causes malocclusion.