Thalassemia Major and related Dentomaxillofacial Complications: Clinical and Radiographic Overview with Reference to Dental Care

Abstract

ABSTRACT Introduction Thalassemia is one of the most common genetic disorders worldwide and presents public health and social challenges in areas of high incidence. Thalassemia major (TM) type is associated with most severe clinical changes. Aim To evaluate dental and oromaxillofacial features of TM. Materials and methods The sample consisted of 54 children and adolescents with TM, 31 males and 23 females, aged 5.5 to 18.3 years (mean age 11.6 ± 3.2 years) and thalassemia-free controls. They were examined for dental caries, oral hygiene, periodontal status, orofacial features, tooth size and dental arch dimensions, dental development, and physical pattern. Clinical, radiographical, and odontometric assessments were carried out. Results Thalassemia major patients were at high risk of dental caries. The average decayed, missing, filled tooth (DMFT) value was 6.26 for 15-year-olds compared with 4.84 in the control group (p < 0.001). Poor oral hygiene and gingivitis were observed in 61.1 and 92.2% of the thalassemic patients respectively. Clinical orofacial features of TM include frontal bossing, saddle nose, and maxillary protrusion, giving a “chipmunk”-like face. Lip incompetence, dental discoloration, and pallor oral mucosa have been noted. Radiographical examination showed the following: thickened frontal bone, thinned mandibular cortex, and maxillary sinus hypoplasia. Class II malocclusion, significant reduction in tooth size and dental arch dimensions, and delay in dental development were evident. Growth retardation was present in 75.9% of the patients. Conclusion Thalassemia major produces a variety of orofacial and systemic complications that increase with age. Early diagnosis and management allow more favorable prognosis and minimize complication. Clinical significance Dental practitioners, especially working in multiracial communities, require understanding of the complications and management of the disease. How to cite this article Hattab FN. Thalassemia Major and related Dentomaxillofacial Complications: Clinical and Radiographic Overview with Reference to Dental Care. Int J Experiment Dent Sci 2017;6(2):95-104.