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遗传性大疱性表皮松解症患者的口腔健康状况:一项比较性多中心研究。

Oral health status in patients with inherited epidermolysis bullosa: a comparative multicenter study.

出版信息

Quintessence Int. 2023 Jan 13;54(1):34-43. doi: 10.3290/j.qi.b3479975.

Abstract

OBJECTIVE

Epidermolysis bullosa (EB) is a rare genetic mucocutaneous disorder characterized by epithelial fragility leading to blister formation on skin and mucous membranes with even minor mechanical trauma. Most EB oral health publications give fragmented information, focusing on only one oral health aspect or one EB type. The aim of this study was to expand the knowledge of the overall oral health status of individuals with dystrophic, junctional, and simplex EB.

METHOD AND MATERIALS

A comparative multicenter study, including a control group, and based on questionnaires and clinical examinations, was undertaken in three EB expert centers.

RESULTS

Most EB (90.2%) participants brushed their teeth at least once a day despite the pain. The prevalence of enamel defects and caries experience did not differ between the 42 EB participants and the 42 age-/sex-matched healthy controls. Gingival inflammation unrelated to dental plaque accumulation was found in EB participants. Blisters, erythema, and erosion/ulceration mainly involved gingiva, buccal mucosa, lips, and palate, with different topographic patterns according to EB type. EB patients whatever the age showed a similar lesion distribution. Simplex and dystrophic EB patients under 12 years old displayed higher lesion severity than junctional EB ones. Only dystrophic type exhibited microstomia and ankyloglossia.

CONCLUSION

Oral health status seemed to benefit from a close collaboration between dental practitioner and dermatologist, and from regular dental examination, starting at a young age and with a focus on prevention. The new appreciation of oral health involvement highlighted by this study is essential for EB patients care, regarding comorbidities and quality of life.

摘要

目的

大疱性表皮松解症(EB)是一种罕见的遗传性黏膜皮肤疾病,其特征为上皮组织脆弱,导致皮肤和黏膜出现水疱,即使受到轻微的机械性创伤也会如此。大多数 EB 口腔健康相关出版物提供的信息较为零散,仅关注口腔健康的一个方面或一种 EB 类型。本研究旨在扩大对营养不良型、交界型和单纯型 EB 个体整体口腔健康状况的认识。

方法与材料

这是一项在三个 EB 专家中心开展的比较性多中心研究,包括一个对照组,基于问卷调查和临床检查进行。

结果

尽管存在疼痛,大多数 EB(90.2%)患者仍每天至少刷牙一次。42 名 EB 参与者和 42 名年龄/性别匹配的健康对照者的牙釉质缺陷和龋齿患病率没有差异。EB 参与者存在与牙菌斑积累无关的牙龈炎症。水疱、红斑和侵蚀/溃疡主要累及牙龈、颊黏膜、嘴唇和 palate,根据 EB 类型呈现不同的形态。无论年龄大小,EB 患者均表现出相似的病变分布。年龄小于 12 岁的单纯型和营养不良型 EB 患者的病变严重程度高于交界型 EB 患者。只有营养不良型 EB 表现出小口畸形和舌系带过短。

结论

通过牙医和皮肤科医生的密切合作,以及定期的牙科检查,从幼年开始并注重预防,口腔健康状况似乎得到了改善。本研究强调了口腔健康状况的重要性,这对于 EB 患者的护理至关重要,不仅涉及到并发症,还涉及到生活质量。

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