Rev. Bras. Hematol. Hemoter. vol.38 número2

(1)

rev bras hematol hemoter. 2016;38(2):97–98

w w w . r b h h . o r g

Revista

Brasileira

de

Hematologia

e

Hemoterapia

Brazilian

Journal

of

Hematology

and

Hemotherapy

Scientific

Comment

on:

“Oral

health-related

quality

of

life

in

children

and

teens

with

sickle

cell

disease”

夽

Maria

Elvira

Pizzigatti

Correa

UniversidadeEstadualdeCampinas(UNICAMP),Campinas,SP,Brazil

a

r

t

i

c

l

e

i

n

f

o

Articlehistory:

Availableonline19March2016

Sicklecelldisease(SCD)isaninheritedredbloodcelldisorder,

characterizedbychronichemolysis,vaso-occlusive

complica-tionsandprogressivemulti-organdamage,withmajorimpact

onthepatients’lifeexpectancyandqualityoflife.1,2_The

inci-denceofSCD isestimatedasmorethan300000newcases

worldwideperyear.3_The_estimated_incidence_of_SCD_in_Brazil

is3500newcasesperyear.4

SCD presents importantmaxillofacial features. Hypoxia

relatedtoSCDhasbeenassociatedwithosteomyelitisofthe

jaws,particularlythemandible.Neuropathiesofthemental

nerveduetoosteomyelitisofthemandiblecausenumbnessin

thelowerlipandchin.Additionally,adiminishedbloodsupply

toteethmaycausenecrosisofthedentalpulp.Bonemarrow

hyperplasiamayresultindepressionofthenasalbridge,

mid-facialovergrowthandmalocclusioninthispatientpopulation.

SCDhasbeenassociatedwithmoderatetoverysevere

mal-occlusion,withanteriortoothloss,anteriorsparing,overjet,

anteriorcrossbiteandopenbite.5,6

Despitethemaxillofacialalterations,SCDhaslittle

influ-enceonoralhealthandnoinfluenceontheincidenceofdental

decay7–10 _{demonstrating} _that _known _risk_factors _for _caries

influenceoralhealthmoremarkedlythanfactorsrelatedto

SCD.11,12

Ontheother hand,inSCD,alterations relatedtodental

occlusionhave a strong influence on the quality oflife of

manypatients. InastudyofSCDinvolving35 five-year-old

DOIoforiginalarticle:http://dx.doi.org/10.1016/j.bjhh.2016.01.004.

夽

SeepaperbyMazzolaetal.inRevBrasHematolHemoter.2015;37(5):336–40.

E-mailaddress:elvira@unicamp.br

childrenand36adolescentsofbothgendersagedbetween12

and18years,theprevalenceofmalocclusioninthepreschool

childrenwas62.9%.Themainmalocclusionsobservedinthis

age group were Class II (37.1%), increased overjet (28.6%),

reduced overbite (28.6%), and open bite (17.1%). All 12- to

18-year-oldsubjectshadmalocclusion,withthemost

preva-lent types of malocclusion being maxillary overjet (63.9%)

andmaxillarymisalignment(58.3%).Itisnoteworthythatthe

majorityofadolescents(80.6%)hadverysevereordisabling

malocclusions.13

InthecurrentissueoftheRevistaBrasileirade

Hematolo-giaeHemoterapia,Fernandesetal.presentastudyinwhich

theyinvestigatedtheinfluenceofSCD,socioeconomic

charac-teristics,andoralconditionsonoralhealth-relatedqualityof

life(OHRQoL)ofchildrenandteens.Thestudydemonstrated

nosignificantdifferenceinthenegativeimpactonOHRQoL

betweenSCD patientsandthehealthy controlgroup.

How-ever,therewasagreaternegativeimpactduetomalocclusion

inadolescentswithSCDcomparedtohealthycontrols.

Thisresulthasalsobeenobservedinotherpatient

popu-lations. Itwasshownthatchildrenand adolescentsexpect

thatorthodontictreatmentwillimprovetheirdental

appear-anceandqualityoflife.14_According_to_{Thiruventadam}_et_al.,

childrenwhosoughtorthodontictreatmenthadlower

qual-ityoflifescoresthanthosewhoneverhadorneversought

orthodontictreatment.15_The_same_observation_was_found_by

http://dx.doi.org/10.1016/j.bjhh.2016.03.001

(2)

98

rev bras hematol hemoter. 2016;38(2):97–98

Kragt et al., who demonstrated a clearinverse association

ofmalocclusionwithpatients’OHRQoL.Theseauthors also

showedthestrengthoftheassociationwasdependentonthe

ageofthechildrenandtheirculturalenvironment.16

Accordingtothe authors,theaesthetic factors thathad

strongrelationshipswiththeneedfororthodontictreatment

were:(1)crooked,crowded,orspacedteeth,(2)worrieswhen

speakingorsmiling,(3)breathsmellandhalitosis,and(4)the

desiretousebraces inordertobelike other peopleor for

fashionablereasons.17

Thereis nodoubt about themaxillofacial alterations in

SCDpatientsandtheimportanceoforthodontictreatmentfor

qualityoflife.Thesestudieshighlighttheneedforabetter

understandingoftheroleandinvolvementofalldental

spe-cialtiesonthecomprehensivetreatmentoftheSCDpatient

population.

Conflicts

of

interest

Theauthordeclaresnoconflictsofinterest.

r

e

f

e

r

e

n

c

e

s

1. PlattOS,BrambillaDJ,RosseWF,MilnerPF,CastroO, SteinbergMH,etal.Mortalityinsicklecelldisease.Life expectancyandriskfactorsforearlydeath.NEnglJMed. 1994;330(23):1639–44.

2. PanepintoJA,O’MaharKM,DeBaunMR,LoberizaFR,ScottJP. Health-relatedqualityoflifeinchildrenwithsicklecell disease:childandparentperception.BrJHaematol. 2005;130(3):437–44.

3. PielFB,HaySI,GuptaS,WeatherallDJ,WilliamsTN.Global burdenofsicklecellanaemiainchildrenunderfive, 2010–2050:modellingbasedondemographics,excess mortality,andinterventions.PLOSMed.2013;10(7):e1001484.

4. MinistériodaSaúdedoBrasil,[Internet]Availablefrom:

http://bvsms.saude.gov.br/bvs/publicacoes/manualeducacao saudev2.pdf[accessed28.2.16].

5. CostaCP,CarvalhoHL,SouzaSdeF,ThomazEB.Issicklecell anemiaariskfactorforseveredentalmalocclusion?BrazOral Res.2015;29.

6.DacostaOO,KehindeMO,IbidapoMO.Occlusalfeaturesof sicklecellanaemiapatientsinLagos,Nigeria.NigerPostgrad MedJ.2005;12(2):121–4.

7.RalstromE,daFonsecaMA,RhodesM,AminiH.Theimpact ofsicklecelldiseaseonoralhealth-relatedqualityoflife. PediatrDent.2014;36(1):24–8.

8.FernandesML,KawachiI,Corrêa-FariaP,PattusiMP,PaivaSM, PordeusIA.Cariesprevalenceandimpactonoral

health-relatedqualityoflifeinchildrenwithsicklecell disease:cross-sectionalstudy.BMCOralHealth.2015; 15:68.

9.Al-AlawiH,Al-JawadA,Al-ShayebM,Al-AliA,Al-KhalifaK. Theassociationbetweendentalandperiodontaldiseasesand sicklecelldisease.Apilotcase–controlstudy.SaudiDentJ. 2015;27(1):40–3.

10.PassosCP,SantosPR,AguiarMC,CangussuMC,TorallesMB, daSilvaMC,etal.Sicklecelldiseasedoesnotpredisposeto cariesorperiodontaldisease.SpecCareDent.2012;32(2): 55–60.

11.JavedF,CorreaFO,NoohN,AlmasK,RomanosGE,Al-Hezaimi K.Orofacialmanifestationsinpatientswithsicklecell disease.AmJMedSci.2013;345(3):234–7.

12.LaurenceB,GeorgeD,WoodsD,ShosanyaA,KatzRV, LanzkronS,etal.Theassociationbetweensicklecelldisease anddentalcariesinAfricanAmericans.SpecCareDent. 2006;26(3):95–100.

13.AlveseLunaAC,GodoyF,deMenezesVA.Malocclusionand treatmentneedinchildrenandadolescentswithsicklecell disease.AngleOrthod.2014;84(3):467–72.

14.TwiggeE,RobertsRM,JamiesonL,DreyerCW,SampsonWJ. Thepsycho-socialimpactofmalocclusionsandtreatment expectationsofadolescentorthodonticpatients.EurJOrthod. 2015,pii:cjv093.

15.ThiruvenkadamG,AsokanS,JohnJB,GeethaPriyaPR, PrathibaJ.Oralhealth-relatedqualityoflifeofchildren seekingorthodontictreatmentbasedonchildoralhealth impactprofile:across-sectionalstudy.ContempClinDent. 2015;6(3):396–400.

16.KragtL,DhamoB,WolviusEB,OngkosuwitoEM.Theimpact ofmalocclusionsonoralhealth-relatedqualityoflifein children–asystematicreviewandmeta-analysis.ClinOral Investig.2015[Epubaheadofprint].