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成骨不全症患儿经双磷酸盐治疗后的乳磨牙牙根吸收和前磨牙牙胚发育情况,按年龄和性别分组。

Root resorption of primary molars and dental development of premolars in children with Osteogenesis Imperfecta medicated with bisphosphonates, grouped according to age and gender.

机构信息

Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain.

出版信息

BMC Oral Health. 2024 Jul 28;24(1):857. doi: 10.1186/s12903-024-04557-3.

Abstract

BACKGROUND

Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and skeletal alterations. The administration of bisphosphonates (BPs) to patients with OI reduces pain, thereby improving their quality of life. The main mechanism of action of BPs is the inhibition of osteoclast action. In the oral cavity of children with OI during growth and development, physiological processes that require the function of osteoclasts occur. The aim of this investigation was to study the dental development of premolars and the root resorption of primary molars in children with OI medicated with BPs according to age and sex.

METHODS

An observational and analytical study was designed. The study sample consisted of 26 6- to 12-year-old children with a confirmed diagnosis of OI treated with BPs with available panoramic radiographs. The control group consisted of 395 children with available panoramic radiographs. Both groups were divided into subgroups according to sex and age. The third quadrant was studied, focusing on the first left temporary molar (7.4), the second left temporary molar (7.5), the first left permanent premolar (3.4) and the second left permanent premolar (3.5). The Demirjian method was used to study the dental development of 3.4 and 3.5, and the Haavikko method was used to study the root resorption of 7.4 and 7.5. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance.

RESULTS

The mean chronological age of the 421 patients was 9.21 years (95% CI 9.05-9.37). The sample was reasonably balanced by sex, with 52.5% (221 patients) boys versus 47.5% (200 patients) girls. Delayed exfoliation and tooth development were described in children with OI (p = 0.05). According to sex, the root resorption of primary molars and tooth development were significantly lower in boys in both groups and in girls in the OI group, but the differences between the age groups were not significant.

CONCLUSIONS

Children with OI treated with BPs exhibit delayed dental development of the premolars and delayed root resorption of the primary molars. Boys exhibited delays in both variables, but the differences by age subgroup were not significant. These clinical findings support the importance of clinically and radiographically monitoring the dental development and root resorption of primary teeth in children with OI treated with BPs to avoid alterations of the eruptive process.

摘要

背景

成骨不全症(OI)是一种以骨骼脆弱和骨骼改变为特征的遗传性疾病。双膦酸盐(BPs)的给药可以减轻 OI 患者的疼痛,从而提高他们的生活质量。BPs 的主要作用机制是抑制破骨细胞的作用。在生长发育中的 OI 儿童的口腔中,发生需要破骨细胞功能的生理过程。本研究旨在根据年龄和性别研究接受 BPs 治疗的 OI 儿童的前磨牙牙胚发育和乳磨牙牙根吸收情况。

方法

设计了一项观察性和分析性研究。研究样本包括 26 名 6 至 12 岁、经 BPs 治疗且有全景片的 OI 确诊儿童,对照组由 395 名有全景片的儿童组成。两组均按性别和年龄分组。研究了第三象限,重点关注左侧第一乳磨牙(7.4)、左侧第二乳磨牙(7.5)、左侧第一恒前磨牙(3.4)和左侧第二恒前磨牙(3.5)。采用 Demirjian 法研究 3.4 和 3.5 的牙胚发育,采用 Haavikko 法研究 7.4 和 7.5 的牙根吸收。采用 Mann-Whitney U 检验进行比较,p<0.05 表示具有统计学意义。

结果

421 名患者的平均年龄为 9.21 岁(95%CI 9.05-9.37)。按性别分组,样本基本平衡,男孩占 52.5%(221 名),女孩占 47.5%(200 名)。OI 患儿描述了牙齿迟萌和发育迟缓(p=0.05)。按性别分组,两组男孩的乳磨牙牙根吸收和牙胚发育明显低于女孩,而各年龄组之间无显著差异。

结论

接受 BPs 治疗的 OI 儿童前磨牙牙胚发育延迟,乳磨牙牙根吸收延迟。男孩在这两个变量上都有延迟,但亚组年龄之间没有差异。这些临床发现支持在临床上和放射学上监测接受 BPs 治疗的 OI 儿童的乳牙牙胚发育和牙根吸收的重要性,以避免萌出过程的改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab84/11283712/4159cbe3069b/12903_2024_4557_Fig1_HTML.jpg

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