J Am Dent Assoc. 2020 Sep;151(9):668-677.e9. doi: 10.1016/j.adaj.2020.05.023.
Sickle cell disease (SCD) is an emerging global health issue with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on dental treatment of SCD.
Using a scoping review approach, the authors examined citations from 13 national SCD guidelines and 10 books spanning 4 decades. The authors also searched the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Scientific Electronic Library Online, and GoogleScholar. Eligibility criteria included SCD, oral health care and dental treatment, related to oral and systemic health, original data, or observations.
Systemic treatment of SCD might have opposing effects on caries, perhaps explaining the conflicting results published. Malocclusion correlates with marrow expansion. Other unusual orofacial findings reflect ischemia. Of 86 full-text articles examined, only 1, a Brazilian esthetic dentistry study, was a randomized clinical trial. No disease-specific data were found on risk of developing bacterial endocarditis, safety of inhaled nitrous oxide, safety of epinephrine with local anesthetic, or the benefit of comprehensive oral health care.
In SCD, oral health and systemic health could be strongly linked. Penicillin, vaccines, and hydroxyurea might impact caries and bone. The interaction of SCD treatments and oral health merit study.
镰状细胞病（SCD）是一个新兴的全球健康问题，尤其是自 2017 年以来，治疗方法取得了快速进展。然而，系统评价并未发现关于 SCD 牙科治疗的临床试验。
作者采用范围综述方法，检查了 13 项国家 SCD 指南和 10 本跨越 40 年的书籍中的参考文献。作者还检索了以下数据库：PubMed、Cumulative Index to Nursing and Allied Health Literature、ScienceDirect、Scientific Electronic Library Online 和 Google Scholar。纳入标准包括 SCD、口腔保健和牙科治疗、与口腔和全身健康相关、原始数据或观察结果。
SCD 的全身治疗可能对龋齿产生相反的影响，这也许可以解释发表的相互矛盾的结果。错颌畸形与骨髓扩张相关。其他不寻常的口腔颌面部发现反映了缺血。在 86 篇全文文章中，只有 1 篇巴西美学牙科研究是随机临床试验。未发现关于细菌心内膜炎风险、吸入一氧化二氮安全性、局部麻醉剂中肾上腺素安全性或全面口腔保健益处的特定疾病数据。
在 SCD 中，口腔健康和全身健康可能密切相关。青霉素、疫苗和羟基脲可能会影响龋齿和骨骼。SCD 治疗和口腔健康的相互作用值得研究。
