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成骨不全症患者全景片的牙科改变与临床诊断、严重程度和双膦酸盐方案相关:一项符合 STROBE 标准的病例对照研究。

Dental alterations on panoramic radiographs of patients with osteogenesis imperfecta in relation to clinical diagnosis, severity, and bisphosphonate regimen aspects: a STROBE-compliant case-control study.

机构信息

Postgraduate Program in Dentistry, Department of Clinical Dentistry, Federal University of Ceará, Fortaleza, Brazil; Professor, School of Dentistry, Christus University Center, Fortaleza, Brazil.

Professor, School of Medicine, Christus University Center, Fortaleza, Brazil; Division of Genetics, Children's Hospital Albert Sabin, Fortaleza, Brazil.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Dec;128(6):621-630. doi: 10.1016/j.oooo.2019.07.001. Epub 2019 Jul 17.

Abstract

OBJECTIVE

This study aimed to assess the prevalence of dental findings on panoramic radiographs (PRs) of patients with osteogenesis imperfecta (OI) and correlate these results with epidemiologic and medical data.

STUDY DESIGN

A case-control study was conducted with 24 patients with OI and 48 sex- and age-matched controls. Demographic, clinical, and bisphosphonate regimen-related data were recorded. The outcome variables were the presence or absence of dental alterations in PRs. Mann-Whitney U test, Pearson's χ test, and multinomial logistic regression analysis (95% confidence interval) were used (significance level of 5%).

RESULTS

OI type 4 demonstrated a high prevalence (62.5%), followed by type 1 (37.5%). With regard to prevalence associated with severity, the moderate form was the most prevalent (P = .028). The mean time of intravenous pamidronate regimen was 6.6 ± 4.4 years. Dentinogenesis imperfecta was observed in 75% of patients with OI, and this group showed a high prevalence of dental abnormalities in comparison with controls (P < .05). Bisphosphonate therapy was associated with ectopic teeth (P = .007) and tooth impaction (P = .033). Pulp obliteration was significant with bisphosphonate treatment over a period of 7 years (P = .026).

CONCLUSIONS

This study found a significant prevalence of dental alterations in patients with OI, and certain alterations were associated with bisphosphonate therapy, indicating its influence on the dentin-related physiopathology.

摘要

目的

本研究旨在评估成骨不全症(OI)患者全景放射影像(PR)的牙科表现,并将这些结果与流行病学和医学数据相关联。

研究设计

进行了一项病例对照研究,纳入 24 例 OI 患者和 48 名性别和年龄匹配的对照。记录了人口统计学、临床和双膦酸盐方案相关数据。结局变量为 PR 中是否存在牙科改变。采用 Mann-Whitney U 检验、Pearson χ检验和多项逻辑回归分析(95%置信区间)(显著性水平为 5%)。

结果

OI 4 型的发病率较高(62.5%),其次是 1 型(37.5%)。就严重程度相关的发病率而言,中度形式最为常见(P=0.028)。静脉帕米膦酸钠方案的平均时间为 6.6±4.4 年。75%的 OI 患者存在牙本质发育不全,与对照组相比,该组的牙科异常发病率较高(P<.05)。双膦酸盐治疗与异位牙(P=0.007)和牙齿阻生(P=0.033)有关。双膦酸盐治疗超过 7 年与牙髓闭塞有关(P=0.026)。

结论

本研究发现 OI 患者的牙科改变发病率显著,某些改变与双膦酸盐治疗有关,表明其对牙本质相关病理生理学的影响。

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