Department of Pediatric Dentistry, Medical University of Warsaw, Miodowa 18, Warsaw, Poland.
Department of Experimental Statistics and Bioinformatics, Warsaw University of Life Sciences, Nowoursynowska 159, Warsaw, Poland.
Clin Oral Investig. 2019 Mar;23(3):1331-1339. doi: 10.1007/s00784-018-2559-y. Epub 2018 Jul 14.
To assess the significance of changes in the saliva in the etiology of gingivitis and tooth wear in children and adolescents with Prader-Willi syndrome (PWS).
The study included 80 (2.8-18 years old; 39 girls and 41 boys): 40 in PWS group (mean age 8.0 ± 4.24 years) and 40 in control group (mean age 7.9 ± 4.12 years). General condition, oral para-functional habits, tooth wear (modified TWI), oral hygiene and gingival status (Plaque Index (PLI) and Gingival Index (GI)), localization of gingivitis, and salivary characteristics were assessed. The chi-square test, the Mann-Whitney U test, Spearman's rank correlation, and odds ratio based on logistic regression in a statistical analysis were applied.
Chances of gingivitis were increased by low PLI (odds ratio (OR) = 32.53), low resting salivary flow (OR = 3.96), increased viscosity of saliva (OR = 3.54), and mouth breathing (OR = 8.17). For gingivitis in anterior regions, low PLI (OR = 107.67), low resting (OR = 5.73) and stimulated (OR = 1.86) salivary flow, increased viscosity of saliva (OR = 5.87), mouth breathing (OR = 10.00), and low stimulated salivary flow (OR = 3.18) were observed. Tooth wear rates were increased by teeth grinding (OR = 16.20), mouth breathing (OR = 4.33), increased viscosity of saliva (OR = 11.67) and low resting (OR = 6.07), and stimulated (OR = 4.22) salivary flow.
In PWS, reduced salivary secretion, increased viscosity, of saliva and mouth breathing increase the risk of plaque-induced gingivitis and tooth wear.
The prevention and treatment of tooth wear and gingivitis in PWS patients is necessary not only to treat bruxism and mouth breathing but also to limit the influence of negative changes of saliva.
评估唾液变化在儿童和青少年普拉德-威利综合征（PWS）患者龈炎和牙齿磨损病因学中的意义。
本研究纳入 80 例患者（2.8-18 岁；39 名女孩和 41 名男孩）：PWS 组 40 例（平均年龄 8.0±4.24 岁），对照组 40 例（平均年龄 7.9±4.12 岁）。评估一般情况、口腔副功能习惯、牙齿磨损（改良 TWI）、口腔卫生和牙龈状况（菌斑指数（PLI）和牙龈指数（GI））、龈炎定位和唾液特征。在统计学分析中应用卡方检验、Mann-Whitney U 检验、Spearman 秩相关和基于逻辑回归的比值比。
低 PLI（比值比（OR）=32.53）、低静息唾液流量（OR=3.96）、唾液黏度增加（OR=3.54）和口呼吸（OR=8.17）增加了龈炎的发生几率。对于前牙区的龈炎，低 PLI（OR=107.67）、低静息（OR=5.73）和刺激（OR=1.86）唾液流量、唾液黏度增加（OR=5.87）、口呼吸（OR=10.00）和低刺激唾液流量（OR=3.18）也与该病相关。磨牙（OR=16.20）、口呼吸（OR=4.33）、唾液黏度增加（OR=11.67）、低静息（OR=6.07）和刺激（OR=4.22）唾液流量增加了牙齿磨损率。
在 PWS 中，唾液分泌减少、黏度增加和口呼吸增加了菌斑引起的龈炎和牙齿磨损的风险。
PWS 患者不仅需要治疗磨牙症和口呼吸，还需要限制唾液负性变化的影响，以预防和治疗牙齿磨损和龈炎。
