TAKO-centre, Lovisenberg Diakonale Hospital, Lovisenberggt 17, 0440 Oslo, Norway.
BMC Oral Health. 2012 May 28;12:12. doi: 10.1186/1472-6831-12-12.
Prader-Willi syndrome (PWS) is a rare complex multsystemic genetic disorder characterized by severe neonatal hypotonia, endocrine disturbances, hyperphagia and obesity, mild mental retardation, learning disabilities, facial dysmorphology and oral abnormalities. The purpose of the present study was to explore the prevalence of tooth wear and possible risk factors in individuals with Prader-Willi syndrome.
Forty-nine individuals (6-40 years) with PWS and an age- and sex-matched control group were included. Tooth wear was evaluated from dental casts and intraoral photographs and rated by four examiners using the Visual Erosion Dental Examination (VEDE) scoring system and the individual tooth wear index IA. In accordance with the VEDE scoring system, tooth wear was also evaluated clinically. Whole saliva was collected.
Mean VEDE score was 1.70 ± 1.44 in the PWS group and 0.46 ± 0.36 in the control group (p < 0.001). Median IA was 7.50 (2.60-30.70) in the PWS group and 2.60 (0.90-4.70) among controls (p < 0.001). In the PWS group tooth wear correlated significantly with age (VEDE; r = 0.79, p < 0.001, IA; r = 0.82, p < 0.001) and saliva secretion (VEDE; r = 0.46, p = 0.001, IA; r = 0.43, p = 0.002). Tooth grinding was also associated with tooth wear in the PWS group, as indicated by the mean VEDE 2.67 ± 1.62 in grinders and 1.14 ± 0.97 in non-grinders (p = 0.001) and median IA values 25.70 (5.48-68.55) in grinders and 5.70 (1.60-9.10) in non-grinders (p = 0.003). Multivariate linear regression analysis was performed with tooth wear as the dependent variable and PWS (yes/no), age, tooth grinding and saliva secretion as independent variables. PWS (yes/no), age and tooth grinding retained a significant association with tooth wear, VEDE (p < 0.001) and log IA (p < 0.001). The only factor significantly associated with tooth wear in the control group was age.
Our study provides evidence that tooth wear, in terms of both erosion and attrition, is a severe problem in Prader-Willi syndrome. There is therefore considerable need for prosthodontic rehabilitation in young adults with PWS.
普拉德-威利综合征（PWS）是一种罕见的复杂多系统遗传性疾病，其特征为新生儿严重的低张力、内分泌紊乱、贪食和肥胖、轻度智力障碍、学习障碍、面部畸形和口腔异常。本研究的目的是探讨普瑞德-威利综合征患者牙齿磨损的流行情况及其可能的危险因素。
纳入 49 名 PWS 患者（6-40 岁）和年龄及性别匹配的对照组。通过牙科模型和口腔内照片评估牙齿磨损情况，并由四名检查者使用视觉侵蚀性牙科检查（VEDE）评分系统和个体牙齿磨损指数 IA 进行评分。根据 VEDE 评分系统，还对牙齿磨损进行了临床评估。收集全唾液。
PWS 组的平均 VEDE 评分为 1.70±1.44，对照组为 0.46±0.36（p<0.001）。PWS 组的中位数 IA 为 7.50（2.60-30.70），对照组为 2.60（0.90-4.70）（p<0.001）。在 PWS 组中，牙齿磨损与年龄（VEDE；r=0.79，p<0.001，IA；r=0.82，p<0.001）和唾液分泌（VEDE；r=0.46，p=0.001，IA；r=0.43，p=0.002）显著相关。磨牙也与 PWS 组的牙齿磨损有关，磨牙者的平均 VEDE 为 2.67±1.62，非磨牙者为 1.14±0.97（p=0.001），中位数 IA 值分别为 25.70（5.48-68.55）和 5.70（1.60-9.10）（p=0.003）。以牙齿磨损为因变量，PWS（是/否）、年龄、磨牙和唾液分泌为自变量进行多元线性回归分析。PWS（是/否）、年龄和磨牙与牙齿磨损（VEDE，p<0.001；logIA，p<0.001）仍存在显著相关性。在对照组中，唯一与牙齿磨损显著相关的因素是年龄。
本研究表明，在普瑞德-威利综合征中，牙齿侵蚀和磨损都存在严重的问题。因此，对于年轻的 PWS 患者，有相当大的修复需求。
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