Knoll Sharon, Janal Malvin, Khocht Ahmed
University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
J Int Acad Periodontol. 2008 Jan;10(1):16-21.
Down syndrome (DS) is a neurodevelopmental genetic disorder affecting millions of Americans. Previous studies, mainly in Caucasians, have shown periodontitis to be a major oral health problem among DS patients. Other research has shown that African-Americans (AA) are more susceptible to periodontitis than Caucasians. Our objective was to determine if DS negatively affects the already impaired periodontal status of AAs.
Radiographic alveolar bone levels were used to determine periodontal status. Full-mouth series of intraoral periapical (PA) radiographs of 25 AA DS patients (age range 18-64 years, 36% males) were randomly selected from a special care dental center for the handicapped. PA radiographs of 25 AA mentally challenged (MC) non-Down patients were also selected from the same center. MC patients were matched to DS patients on variables of race, age, sex, socioeconomic status and institutionalized care. All periapical radiographs were taken with a long cone paralleling technique under normal clinical practice conditions. Under standardized viewing conditions, the distance from the cementoenamel junction to the interproximal alveolar crest on both the mesial and distal surfaces of each fully erupted permanent tooth present was measured. A paired samples t-test was used to compare the radiographic bone levels of DS and MC subjects.
All subjects showed sites with bone loss > or = 3 mm. Whole mouth mean (SD) bone level for DS subjects was 3.0 (1.5) mm and for MC subjects it was 1.9 (1.1) mm, p = 0.001. This finding was replicated in the various regions in the mouth where DS patients showed greater bone loss than MC patients in anterior regions (incisors and canines, p = 0.001), in posterior regions (molars and premolars, p = 0.007), in maxillary regions (p = 0.001) and in mandibular regions (p = 0.005).
Periodontitis is a problem in AA patients. Adding the genetic disorder of DS to AA race imposes additional risks for periodontitis.
唐氏综合征（DS）是一种影响数百万美国人的神经发育性遗传疾病。以往主要针对白种人的研究表明，牙周炎是DS患者中的一个主要口腔健康问题。其他研究表明，非裔美国人（AA）比白种人更容易患牙周炎。我们的目的是确定DS是否会对AA患者本已受损的牙周状况产生负面影响。
采用口腔X光片牙槽骨水平来确定牙周状况。从一家特殊护理牙科中心为残障人士中随机选取25名AA型DS患者（年龄范围18 - 64岁，36%为男性）的全口系列口腔根尖片（PA）。还从同一中心选取了25名AA型智力障碍（MC）非唐氏患者的PA片。MC患者在种族、年龄、性别、社会经济地位和机构护理等变量上与DS患者相匹配。所有根尖片均在正常临床实践条件下采用长锥平行技术拍摄。在标准化观察条件下，测量每个完全萌出恒牙的近中面和远中面从牙骨质釉质界到邻间牙槽嵴的距离。采用配对样本t检验比较DS和MC受试者的X光片骨水平。
所有受试者均显示有骨丧失≥3mm的部位。DS受试者全口平均（标准差）骨水平为3.0（1.5）mm，MC受试者为1.9（1.1）mm，p = 0.001。这一发现在口腔的各个区域都得到了验证，DS患者在前牙区（切牙和尖牙，p = 0.001）、后牙区（磨牙和前磨牙，p = 0.007）、上颌区（p = 0.001）和下颌区（p = 0.005）的骨丧失均比MC患者更严重。
牙周炎是AA患者面临的一个问题。AA种族中增加DS这种遗传疾病会带来额外的牙周炎风险。
