Poberezhnaya A A, Korolenkova M V
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
Stomatologiia (Mosk). 2021;100(1):55-59. doi: 10.17116/stomat202110001155.
Was to assess age-related changes in mouth opening and tongue mobility in children with various forms of epidermolysis bullosa (EB). Materials and methods. The study comprised 50 EB children (mean age 8.8±3.9 years). Oral slit width (the distance between mouth commissures at rest), mouth opening amplitude (the distance between incisive edges of the lower and upper incisors) were measured by orthodontic caliper. Tongue mobility was assessed using Bristol Tongue Assessment Tools (BTAT). The results were compared with 55 healthy age-matched controls (mean age 9.3±3.7 years).
Mean moth opening in EB group was 22.6±11.1 mm which is twice lower than in controls (44.3±7.2 mm). The amplitude was progressively increasing in EB patients in the mixed dentition period but then dropped drastically in the permanent dentition because of oral fibrosis. Tongue mobility was lower in EB group when compared to controls even in cases with anatomically appropriate frenulum fixation sites. In permanent dentition maximal tongue raising was 8 times lower than in controls. Microstomia and ankyloglossia were very specific for dystrophic EB patients while in EB simplex, junctional EB and Kindler syndrome the values were similar to healthy controls.
Microstomia, limited mouth opening and tongue mobility are typical oral features of dystrophic EB patients. Age-related dynamics shows progressive growth of the values in mixed dentition with significant lowering after so preventive measures for oral fibrosis are more feasible before permanent dentition phase.
评估不同类型大疱性表皮松解症(EB)患儿的张口度和舌活动度随年龄的变化。材料与方法。本研究纳入50例EB患儿(平均年龄8.8±3.9岁)。使用正畸卡尺测量口腔裂隙宽度(静息时口角间的距离)、张口幅度(上下切牙切缘间的距离)。使用布里斯托尔舌评估工具(BTAT)评估舌活动度。将结果与55名年龄匹配的健康对照者(平均年龄9.3±3.7岁)进行比较。
EB组平均张口度为22.6±11.1毫米,比对照组(44.3±7.2毫米)低两倍。在混合牙列期,EB患者的张口幅度逐渐增加,但在恒牙列期因口腔纤维化而急剧下降。即使在系带固定部位解剖结构正常的情况下,EB组的舌活动度也低于对照组。在恒牙列期,最大舌上抬幅度比对照组低8倍。小口畸形和舌系带过短在营养不良型EB患者中非常典型,而在单纯型EB、交界型EB和Kindler综合征患者中,这些数值与健康对照者相似。
小口畸形、张口受限和舌活动度受限是营养不良型EB患者典型的口腔特征。与年龄相关动力学显示,混合牙列期这些数值逐渐增加,恒牙列期后显著降低,因此在恒牙列期之前采取预防口腔纤维化的措施更可行。