Download PDF
CC BY 4.0 · Eur J Dent 2024; 18(01): 356-359
DOI: 10.1055/s-0043-1771200
Original Article

Evaluation of Mandibular Bone Microstructure in CT Scans of People with Sickle Cell Disease

Viviane de Sousa Moreira Almeida 
1   School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
,
Mariana Quirino Silveira Soares
2   Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
,
Patricia Miranda Leite-Ribeiro
1   School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
,
Izabel Regina Fischer Rubira-Bullen
2   Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
,
Liliane Elze Falcão Lins-Kusterer
3   Medical School, Federal University of Bahia, Salvador, Bahia, Brazil
,
Viviane Almeida Sarmento
1   School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
› Author Affiliations Funding The authors thank the Brazilian Ministry of Health for funding this study.
› Further Information
   Permissions and Reprints

Abstract

Objective Sickle cell disease (SCD) is a common inherited disease, and is characterized by a genetic modification that determines the production of a hemoglobin with altered morphology. This anatomical change of hemoglobin leads to vaso-occlusive disorders and premature hemolysis of the cell, causing chronic anemia and bone marrow hyperplasia due to increased hematopoietic demand. As a consequence, several skeletal changes are reported in the skull, spine, ribs, pelvis, femur, and metatarsals. In the craniofacial region, dentofacial deformities are described, especially maxillary protrusion. However, studies evaluating bone microarchitecture are scarce. The aim of this study is to evaluate the mandibular bone microstructure of people with SCD on computed tomography (CT) scans.

Materials and Methods Morphometric parameters were analyzed on CT scans of the mandible of people with SCD and people without this disease or any other disease affecting bone metabolism, matched for sex and age.

Statistical Analysis The results were compared by Student's t-test for paired samples and for an error probability of 5%.

Results This study demonstrated that the mandibular bone of people with SCD presents significantly less number, connectivity and thickness of bone trabeculae, as well as having a lower fractal dimension and greater porosity.

Conclusion Mandibular bone of people with SCD has lower bone density and more widely spaced trabeculae.

Keywords

sickle cell disease - computed tomography - bone changes

Ethical Approval Statement

Research Ethics Committee of the Professor Edgard Santos University Hospital of the Federal University of Bahia. CAAE: 273552190.0000.0049.




Publication History

Article published online:
20 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Steer K, Stavnichuk M, Morris M, Komarova SV. Bone health in patients with hematopoietic disorders of bone marrow origin: systematic review and meta-analysis. J Bone Miner Res 2017; 32 (04) 731-742
    CrossrefPubMedGoogle Scholar
  • 2 Rosenfeld LG, Bacal NS, Cuder MAM. et al. Prevalence of hemoglobinopathies in the Brazilian adult population: National Health Survey 2014-2015. Rev Bras Epidemiol 2019 ;22Suppl 02(Suppl 02):E190007.SUPL.2
    PubMedGoogle Scholar
  • 3 Souza S, Carvalho H, Costa C, Thomaz E. Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities. Oral Dis 2018; 24 (03) 393-403
    CrossrefPubMedGoogle Scholar
  • 4 Souza RC, Miranda Neto PAD, Santos JRN. et al. Sickle cell anaemia prevalence among newborns in the Brazilian Amazon-Savanna transition region. Int J Environ Res Public Health 2019; 16 (09) 1638
    CrossrefPubMedGoogle Scholar
  • 5 Arowojolu MO, Savage KO. Alveolar bone patterns in sickle cell anemia and non-sickle cell anemia adolescent Nigerians: a comparative study. J Periodontol 1997; 68 (03) 225-228
    CrossrefPubMedGoogle Scholar
  • 6 McCavit TL. Sickle cell disease. Pediatr Rev 2012; 33 (05) 195-204 , quiz 205–206
    CrossrefPubMedGoogle Scholar
  • 7 Lonergan GJ, Cline DB, Abbondanzo SL. Sickle cell anemia. Radiographics 2001; 21 (04) 971-994
    CrossrefPubMedGoogle Scholar
  • 8 Santos HL, Barbosa IS, Oliveira TFL, Sarmento VA, Trindade SC. Evaluation of the maxillomandibular positioning in subjects with sickle-cell disease through 2- and3-dimensional cephalometric analyses. Medicine (Baltimore) 2018; 97: 25
    CrossrefPubMedGoogle Scholar
  • 9 Baldanzi G, Traina F, Marques Neto JF, Santos AO, Ramos CD, Saad ST. Low bone mass density is associated with hemolysis in Brazilian patients with sickle cell disease. Clinics (São Paulo) 2011; 66 (05) 801-805
    CrossrefPubMedGoogle Scholar
  • 10 Demirbaş Kaya A, Aktener BO, Unsal C. Pulpal necrosis with sickle cell anaemia. Int Endod J 2004; 37 (09) 602-606
    CrossrefPubMedGoogle Scholar
  • 11 de Carvalho HLCC, Rolim JYS, Thomaz ÉBAF, Souza SFC. Are dental and jaw changes more prevalent in a Brazilian population with sickle cell anemia?. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124 (01) 76-84
    CrossrefPubMedGoogle Scholar
  • 12 Adewoye AH, Chen TC, Ma Q. et al. Sickle cell bone disease: response to vitamin D and calcium. Am J Hematol 2008; 83 (04) 271-274
    CrossrefPubMedGoogle Scholar
  • 13 Serindere G, Belgin CA. Evaluation of the effects of hemoglobinopathies on the mandible with fractal dimension analysis. Niger J Clin Pract 2019; 22 (10) 1435-1440
    CrossrefPubMedGoogle Scholar
  • 14 Mercier P. Ridge reconstruction with hydroxylapatite. Part 1. Anatomy of the residual ridge. Oral Surg Oral Med Oral Pathol 1988; 65 (05) 505-510
    CrossrefPubMedGoogle Scholar
  • 15 Green M, Akinsami I, Lin A. et al. Microarchitectural and mechanical characterization of the sickle bone. J Mech Behav Biomed Mater 2015; 48: 220-228
    CrossrefPubMedGoogle Scholar
  • 16 Neves FS, de Almeida DA, Oliveira-Santos C. et al. Radiographic changes of the jaws in HbSS and HbSC genotypes of sickle cell disease. Spec Care Dentist 2011; 31 (04) 129-133
    CrossrefPubMedGoogle Scholar
  • 17 Zlatarić DK, Celebić A. Clinical bone densitometric evaluation of the mandible in removable denture wearers dependent on the morphology of the mandibular cortex. J Prosthet Dent 2003; 90 (01) 86-91
    CrossrefPubMedGoogle Scholar