Evaluation of Mandibular Bone Microstructure in CT Scans of People with Sickle Cell Disease.

Abstract

Sickle cell disease (SCD) is a common inherited disease, and is characterized by a genetic modification that determines the production of a hemoglobin with altered morphology. This anatomical change of hemoglobin leads to vaso-occlusive disorders and premature hemolysis of the cell, causing chronic anemia and bone marrow hyperplasia due to increased hematopoietic demand. As a consequence, several skeletal changes are reported in the skull, spine, ribs, pelvis, femur, and metatarsals. In the craniofacial region, dentofacial deformities are described, especially maxillary protrusion. However, studies evaluating bone microarchitecture are scarce. The aim of this study is to evaluate the mandibular bone microstructure of people with SCD on computed tomography (CT) scans. Morphometric parameters were analyzed on CT scans of the mandible of people with SCD and people without this disease or any other disease affecting bone metabolism, matched for sex and age. The results were compared by Student's t-test for paired samples and for an error probability of 5%. This study demonstrated that the mandibular bone of people with SCD presents significantly less number, connectivity and thickness of bone trabeculae, as well as having a lower fractal dimension and greater porosity. Mandibular bone of people with SCD has lower bone density and more widely spaced trabeculae.