Huang Mei-Li, Wu Ying-Qian, Ruan Wen-Hua
Department of Otolaryngology Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Stomatology, the Children's Hospital, Zhejiang University School of Medicine, National Clinic Research Center for Child Health, Hangzhou, China.
Transl Pediatr. 2020 Oct;9(5):720-725. doi: 10.21037/tp-20-279.
Crohn's disease (CD) is a granulomatous inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract, but its etiology is still unclear. CD patients usually have extraintestinal manifestations including oral manifestations, and this can also occasionally appear in children. Oral manifestations, including aphthous stomatitis, typically develop on the mucocutaneous tissue. As pediatric CD is not common, there have been no reports concerning alveolar bone resorption for these kinds of patients. An 11-year-old Chinese girl was referred to our hospital because of reoccurring painful oral ulcers, with a 2.5-year history of CD and recurrent oral ulcers. Clinical examinations revealed intestinal lesions, oral ulcers, and alveolar bone loss. CD and its related periodontitis were diagnosed. After comprehensive therapy, including periodontal scaling and anti-inflammatory treatment, the oral ulcers gradually healed. One year later, follow-up visit showed the anterior alveolar bone to be stable and new alveolar bone regenerating around the mandibular anterior teeth at some sites. It is rare for CD children to have periodontitis, especially with severe alveolar bone loss. This case suggests that when treating periodontitis in children, the possibility of systemic disease, such as CD, should be considered and attended to. Early diagnosis and symptomatic treatment and care are crucial.
克罗恩病(CD)是一种肉芽肿性炎症性肠病(IBD),可累及胃肠道的任何部位,但其病因仍不清楚。CD患者通常有肠外表现,包括口腔表现,这在儿童中也偶有出现。口腔表现,如阿弗他口炎,通常发生在黏膜皮肤组织上。由于儿童CD并不常见,尚无关于这类患者牙槽骨吸收的报道。一名11岁中国女孩因反复出现疼痛性口腔溃疡被转诊至我院,她有2.5年的CD病史且反复出现口腔溃疡。临床检查发现肠道病变、口腔溃疡和牙槽骨丧失。诊断为CD及其相关的牙周炎。经过包括牙周洁治和抗炎治疗在内的综合治疗,口腔溃疡逐渐愈合。一年后随访显示,前牙槽骨稳定,下颌前牙周围部分部位有新的牙槽骨再生。CD患儿患牙周炎,尤其是伴有严重牙槽骨丧失的情况较为罕见。该病例提示,在治疗儿童牙周炎时,应考虑全身性疾病如CD的可能性并加以关注。早期诊断和对症治疗及护理至关重要。