Atherosclerotic background of disseminated teeth losses in sickle cell diseases

Abstract

Background: We tried to understand whether or not there is an atherosclerotic background of disseminated teeth losses in sickle cell diseases (SCDs). Methods: All patients with the SCDs were included, and cases with disseminated teeth losses (< 20 teeth present) were detected. Results: The study included 434 patients (222 males). Mean ages were similar in males and females (30.8 versus 30.3 years, respectively, P>0.05). Smoking (23.8% versus 6.1%) and alcohol (4.9% versus 0.4%) were higher in males (P<0.001 for both). Although the relatively younger mean ages, the prevalences of disseminated teeth losses were higher both in males and females (5.4% versus 1.4%, respectively, P<0.001). On the other hand, transfused units of red blood cells in their lives (48.1 versus 28.5, P=0.000), chronic obstructive pulmonary disease (25.2% versus 7.0%, P<0.001), ileus (7.2% versus 1.4%, P<0.001), cirrhosis (8.1% versus 1.8%, P<0.001), leg ulcers (19.3% versus 7.0%, P<0.001), digital clubbing (14.8% versus 6.6%, P<0.001), coronary artery disease (18.0% versus 13.2%, P<0.05), chronic renal disease (9.9% versus 6.1%, P<0.05), and stroke (12.1% versus 7.5%, P<0.05) were all higher in males. Conclusion: SCDs are chronic inflammatory processes on vascular endothelium particularly at the capillary level, and terminate with accelerated atherosclerosis induced end-organ failures in early years of life. Although the relatively younger mean ages of the study cases, the higher prevalences of disseminated teeth losses in both genders are probably due to the disseminated endothelial damage, inflammation, and fibrosis both at arterial and venous systems of the oral mucosa, periodontium, and teeth in the SCDs.