Is sickle cell anemia a risk factor for severe dental malocclusion?

The aim of this study was to investigate possible associations between sickle cell anemia (SCA) and the severity of dental malocclusion (MO). This was a retrospective cohort study of 93 individuals with SCA (G1) and 186 individuals without the disease (G2). SCA patients were randomly selected by a simple draw from patients treated in the Centro de Hematologia e Hemoterapia do Maranhão (HEMOMAR) in northeastern Brazil. Patients aged between 16 and 60 were included after being tested for the hemoglobin S gene. G2 consisted of individuals living in the same residence as the patients. The Dental Aesthetic Index (DAI), as well as some morphological deviations not included in DAI, were used for the orthodontic evaluation of MO. Poisson regression with robust variance adjustment was employed to estimate relative risk (RR). In the multivariate analysis, SCA was associated with moderate (RR = 1.36) and very severe MO (RR = 8.0). SCA is correlated with anterior tooth loss (RR = 1.94), anterior spacing (RR = 1.66), overjet (RR = 1.87), anterior crossbite (RR = 1.94), and open bite (RR = 1.94). Thus, SCA is a risk factor for moderate and very severe MO.

本研究旨在探讨镰状细胞贫血（sickle cell anemia, SCA）与牙颌畸形（dental malocclusion, MO）的严重程度之间的潜在关联。本研究为回顾性队列研究，共纳入93名镰状细胞贫血患者（G1组）与186名非该病患者（G2组）。镰状细胞贫血患者通过简单随机抽样，从巴西东北部马拉尼昂州血液学与血液治疗中心（Centro de Hematologia e Hemoterapia do Maranhão, HEMOMAR）收治的患者中抽取。研究纳入年龄介于16至60岁、经血红蛋白S基因检测确诊的患者。G2组受试者为与G1组患者同住的人员。本研究采用牙科美学指数（Dental Aesthetic Index, DAI）及部分未纳入该指数的形态学异常指标，对牙颌畸形开展正畸学评估。采用稳健方差调整泊松回归估算相对危险度（relative risk, RR）。多因素分析结果显示，镰状细胞贫血与中度（RR=1.36）及极重度牙颌畸形（RR=8.0）存在关联。此外，镰状细胞贫血还与前牙缺失（RR=1.94）、前牙间隙（RR=1.66）、覆盖过大（RR=1.87）、前牙反𬌗（RR=1.94）及开𬌗（RR=1.94）相关。综上，镰状细胞贫血是中度及极重度牙颌畸形的危险因素。