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Fulltext Treatment of dental complications in sickle cell disease

Mulimani P, Ballas SK, Abas AB, Karanth L

Cochrane Database Syst Rev, 2019 Dec 16;12(12):CD011633.
PMID: 31841224 DOI: 10.1002/14651858.CD011633.pub3

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health. Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. This is an update of a previously published review.
OBJECTIVES: To assess methods of treating dental complications in people with sickle cell disease.
SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Review Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 01 August 2019. Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field. Date of last search: 07 November 2019.
SELECTION CRITERIA: We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease.
DATA COLLECTION AND ANALYSIS: Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review.
MAIN RESULTS: No randomised controlled studies were identified.
AUTHORS' CONCLUSIONS: This Cochrane Review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.

Matched MeSH terms: Craniofacial Abnormalities/complications
Fulltext Craniofacial morphology of Malay patients with obstructive sleep apnoea

Albajalan OB, Samsudin AR, Hassan R

Eur J Orthod, 2011 Oct;33(5):509-14.
PMID: 21118908 DOI: 10.1093/ejo/cjq108

The aim of this study was to compare the skeletal and soft tissue patterns between obstructive sleep apnoea (OSA) patients and control group of non-OSA patients. Fifty Malays (32 males and 18 females) aged 18-65 years divided into two equal groups 25 (17 males and 8 females) with OSA and a control group 25 subjects (15 males and 10 females). Both groups were diagnosed using polysomnography. Nineteen variables related to craniofacial skeletal and soft tissue morphology were measured on lateral cephalometric films. Analysis of covariance was used to compare the means between the two groups. The results showed that OSA subjects had a significant increase in body mass index (BMI) and neck circumference than the control group. The soft palate and tongue were longer and thicker in OSA patients. In addition, upper, middle, and lower posterior airway spaces were narrower, the hyoid bone was more inferior and posterior, and the cranial base flexure angle was significantly acute when compared with the control group. The findings indicate that craniofacial abnormalities play significant roles in the pathogenesis of OSA in Malay patients.

Matched MeSH terms: Craniofacial Abnormalities/complications*

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