Orofacial Structural Changes in Iraqi Patients with β-Thalassaemia Major

Abstract

Background : Thalassaemia is the most common single gene disorder in the world and represents a major health burden. Oro-facial changes occur during the disease process mainly because of marrow expansion to compensate anemia. The aim of this study :The aim of this study was to evaluate the orofacial structural changes in thalassaemia and to co-relate them to the duration of the disease process and to assess the bone density of both mandibular condyles in β-thalassaemia major patients . Patients,materials and methods: The control group consisted of (16) subjects and the study groups consisted of (52) , each of the study and control groups were divided into three sub groups according to their age and types of collecting data. A coronal view of the image was obtained , the bone density in Hounsfield units (HU) within each (region of interest) roi measured and five units at different locations on the body of condyle obtained , then divided into five ,this represented the mean number of hu of each body of condyle (both right and left head of condyle obtained). Results: The results of the study showed high degree of malocclusion in β-thalassemia patients. There was a significant difference in oral hygiene between thalassaemic patients and control group. The extraoral examination of thalassaemia major patients showed that the facial pigmentation and the saddle nose were significant in thalassemia major patients . In this study the mean value of DMFT index in the study group was (10.905) while the mean value of DMFT index in the control group was 7.875. In comparison between study and control group ,the results were significant for males (P<0.05 ) and highly significant for total (P<0.01), while for females ,the results were significant(P<0.05 ) . The orthopantomography(OPG) assessment of patients showed that the lamina dura around the roots was thinner than usual,enlarged bone marrow spaces ,spiky root of mandibular molars and taurodontism. The assessment of bone density of the head of condyles using quantitive computerised tomography (CT) scan in the study showed that the Hounsfield unit (H.U) of study group were lower than control group which mean that bone density was lower and the Hounsfield unit( H.U )and density of bone decreased with increase the age