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描述智利 X 连锁低磷血症患者的口腔健康状况。

Characterization of Oral Health Status in Chilean Patients with X-Linked Hypophosphatemia.

机构信息

Faculty of Medicine, School of Dentistry, Pontificia Universidad Católica de Chile, Santiago, Chile.

Endocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 262, Cuarto piso, Santiago, Chile.

出版信息

Calcif Tissue Int. 2021 Aug;109(2):132-138. doi: 10.1007/s00223-021-00841-4. Epub 2021 Apr 10.

Abstract

X-Linked Hypophosphatemia (XLH) is the most common cause of inherited hypophosphatemic rickets. Dental involvement, including spontaneous abscesses and/or fistulae, is an important part of the disease and has not been completely defined, especially in cohorts from developing countries. To describe oral health status in a cohort of Chilean patients with XLH and explore its correlation with biochemical presentation and treatment, we conducted a cross-sectional observational study of patients with PHEX mutation-confirmed XLH. All patients had an oral clinical exam, radiographic evaluation; clinical and biochemical data were obtained to determine their association with oral features. Twenty-six patients were included, 77% adults and 23% children. Most adults (89%) had past or current dental pulp pathology (abscesses and/or fistulae). Pulpal chamber enlargement and radiolucent apical lesions were common radiological features (94 and 74%, respectively). In children, abscess and/or fistulae were also common (33%). Caries index, which was determined by dmft/DMFT, was higher than the Chilean national average. Early and long-term therapy with phosphate and activated vitamin D was associated with lower carious index and attachment loss. XLH patients frequently present with high pulpal involvement and carious index. Conventional therapy was associated with lower carious index and attachment loss. These data highlight the importance of early and periodical dental care in order to prevent dental damage and assure a good quality of oral health for XLH patients.

摘要

X 连锁低磷血症(XLH)是遗传性低磷性佝偻病最常见的原因。牙齿受累,包括自发性脓肿和/或瘘管,是该病的重要组成部分,但尚未完全定义,特别是在发展中国家的队列中。为了描述智利 XLH 患者队列的口腔健康状况,并探讨其与生化表现和治疗的相关性,我们对 PHEX 基因突变确认的 XLH 患者进行了横断面观察性研究。所有患者均接受了口腔临床检查、影像学评估;获得了临床和生化数据,以确定它们与口腔特征的相关性。共纳入 26 例患者,77%为成年人,23%为儿童。大多数成年人(89%)有过去或现在的牙髓病理学(脓肿和/或瘘管)。牙髓腔扩大和根尖透亮区是常见的影像学特征(分别为 94%和 74%)。在儿童中,脓肿和/或瘘管也很常见(33%)。通过 dmft/DMFT 确定的龋病指数高于智利全国平均水平。早期和长期用磷酸盐和活性维生素 D 治疗与较低的龋病指数和附着丧失有关。XLH 患者常表现为牙髓高度受累和龋病指数高。常规治疗与较低的龋病指数和附着丧失有关。这些数据强调了早期和定期口腔护理的重要性,以防止牙齿损伤并确保 XLH 患者有良好的口腔健康质量。

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