Department of Oral and Maxillofacial Pathology, Federal University of Para, Belem, Brazil.
Dentomaxillofac Radiol. 2012 Oct;41(7):541-7. doi: 10.1259/dmfr/43023353.
A wide variety of manifestations is presented in patients with Gaucher's disease (GD), including bone, haematology and visceral disturbances. This study was conducted to ascertain the main maxillofacial abnormalities by means of clinical survey, panoramic and cone beam CT (CBCT); to compare the patient's group with an age-sex matched control group; and to correlate clinical and radiological data.
Ten patients previously diagnosed with GD were submitted to clinical and radiological surveys (CBCT and panoramic radiographs). The examination consisted of anamnesis, extra- and intraoral examinations and analyses of each patient's records. Imaging data were collected from the point of view of 3 observers, and the results compared with a healthy group (20 individuals) by means of statistical analysis (Fisher's exact test).
Gaucher patients had significantly more manifestations than otherwise healthy carriers. The most prevalent findings were enlarged marrow spaces, generalized osteopenia and effacement of jaw structures (mandibular canal, lamina dura and mental foramen). Here we describe a case in which thickening of the maxillary sinus mucosa was observed on CBCT rather than opacification of the sinus as seen on panoramic radiographs. Pathological fractures, root resorption and delay on tooth eruption were not observed.
A poor relationship could be observed between clinical and radiological data. Patients showed important bone manifestations, which require careful diagnostic and surgical planning whenever necessary. Although panoramic radiographs have shown significant differences, CBCT is more effective in pointing out differences between patients and a control group, thus showing it as an important tool for evaluation of Gaucher patients.
戈谢氏病(GD)患者表现多样,包括骨骼、血液学和内脏紊乱。本研究旨在通过临床调查、全景和锥形束 CT(CBCT)确定主要的颌面异常;将患者组与年龄性别匹配的对照组进行比较;并对临床和影像学数据进行相关性分析。
10 名先前被诊断为 GD 的患者接受了临床和影像学检查(CBCT 和全景片)。检查包括病史、口内外检查以及对每位患者记录的分析。从 3 位观察者的角度收集影像学数据,并通过统计分析(Fisher 确切检验)将结果与健康组(20 人)进行比较。
GD 患者比健康携带者有更多的表现。最常见的发现是骨髓腔增大、广泛性骨质疏松和颌骨结构(下颌管、硬骨板和颏孔)的消失。我们在此描述了一例 CBCT 上观察到上颌窦黏膜增厚,而全景片上则观察到窦腔混浊的病例。未观察到病理性骨折、牙根吸收和牙齿萌出延迟。
临床和影像学数据之间存在较差的相关性。患者表现出重要的骨骼表现,需要在必要时进行仔细的诊断和手术计划。尽管全景片显示出显著差异,但 CBCT 更能准确指出患者与对照组之间的差异,因此被证明是评估戈谢氏病患者的重要工具。