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多动型埃勒斯-当洛斯综合征患者的口腔-牙科特征与健康对照组比较。

Oro-dental characteristics in patients with hypermobile Ehlers-Danlos Syndrome compared to a healthy control group.

机构信息

Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Resource Center for Rare Oral Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

出版信息

J Oral Rehabil. 2019 Nov;46(11):1055-1064. doi: 10.1111/joor.12838. Epub 2019 Jun 27.

Abstract

BACKGROUND

Ehlers-Danlos syndrome (EDS) is a hereditary disorder that affects the connective tissue and collagen structures in the body characterised by joint hypermobility, skin hyperextensibility and tissue fragility.

OBJECTIVE

The aim of the study was to investigate the oro-dental characteristics including measurements of tooth size of 26 patients with hypermobile EDS (hEDS), differentiated by a genetic test, compared to 39 healthy controls.

METHODS

Interview, clinical and radiological examination on panoramic radiograph and cone-beam computed tomographic (CBCT) scan were performed. Statistical analyses included Fisher's exact test, paired t test and multiple logistic and linear models adjusted for age and gender.

RESULTS

The experience of xerostomia (P = 0.039), local anaesthetic insufficiency (P < 0.001) and tooth extraction complications (P < 0.003) were significantly higher in hEDS compared to controls. The debris index was significantly higher in hEDS (P < 0.001), and the distance between the cement-enamel junction (CEJ) and the bone level on the upper left first incisor and molar and the lower right first molar was significantly larger in hEDS compared to controls (P = 0.021, P = 0.024, P = 0.021, respectively). The crown heights of the upper and lower first incisors were significantly smaller (P = 0.001, P = 0.003, P = 0.002, P < 0.001, respectively) in hEDS compared to controls. When adjusting for debris index, only the distance between CEJ and the marginal bone level on the upper left and lower right molar was associated with hEDS.

CONCLUSION

The results indicate that xerostomia, resistance to local anaesthesia, tooth extraction complications, poor oral hygiene, larger distance between CEJ and marginal bone level and small crown heights can be found in patients with hEDS.

摘要

背景

埃勒斯-当洛斯综合征(EDS)是一种遗传性疾病,影响身体的结缔组织和胶原结构,其特征为关节过度活动、皮肤过度伸展和组织脆弱。

目的

本研究旨在通过基因测试区分出 26 例高活动型 EDS(hEDS)患者,调查其口腔牙科特征,包括牙齿大小的测量,并与 39 名健康对照进行比较。

方法

进行访谈、临床和全景放射影像及锥形束 CT(CBCT)扫描检查。统计分析包括 Fisher 确切检验、配对 t 检验以及调整年龄和性别后进行的多逻辑和线性模型。

结果

hEDS 患者口干(P=0.039)、局部麻醉不足(P<0.001)和拔牙并发症(P<0.003)的体验明显高于对照组。hEDS 的碎屑指数明显更高(P<0.001),并且在上颌左侧第一切牙和磨牙以及下颌右侧第一磨牙的牙釉质-牙骨质交界处(CEJ)和牙槽骨水平之间的距离明显大于对照组(P=0.021,P=0.024,P=0.021,分别)。上颌和下颌第一切牙的冠高明显较小(P=0.001,P=0.003,P=0.002,P<0.001,分别)。在调整碎屑指数后,只有上颌左侧和下颌右侧磨牙的 CEJ 和边缘牙槽骨水平之间的距离与 hEDS 相关。

结论

结果表明,口干、局部麻醉耐药、拔牙并发症、口腔卫生不良、CEJ 和边缘牙槽骨水平之间的距离较大以及冠高较小可能存在于 hEDS 患者中。

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