Macroscopic and radiographic analysis of primary teeth with hyperbilirubinemia in children with chronic liver disease and liver transplantation
DOI:
https://doi.org/10.22456/2177-0018.118701Keywords:
Hyperbilirubinemia, Jaundice, neonatal, Dental enamel, DentinAbstract
Aim: is to identify, through macroscopic and radiographic analysis, structural changes in dental tissues affected by hyperbilirubinemia, usually seen from the clinical sign of icterus and causes the development of intrinsic greenish pigments in dental structure. Materials and Methods: The sample consisted of 31 primary teeth divided into a control group (n=7) and an experimental group (n=24). Macroscopic analyzes were performed using standardized individual photographs and radiographic ones obtained by image acquisition at 9 mA, 70 kVp, 8cm distance, 0.4 seconds exposure and with XDR Sensor®. The images were converted by XDR Brasil 3.1.6 software and standardized by GIMP 2.10.22 software. The Histogram’s simple mean data were analyzed by T-Student and Mann-Whitney tests (p<0.05). Results: showed intensity of pigmentation in the cervical region of the root, with a statistically significant difference in the root portion between the experimental and control groups (p=0.043. In the analysis of radiographic density of the root structure of the experimental group, there was a statistically significant difference (p= 0.016) between the cervical and apical thirds. Discussion: The data showed that teeth pigmented by hyperbilirubinemia do not have changes in mineral density in the coronary thirds. Conclusion: Greenish pigments teeth have differences in radiographic density only in the root structure.
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Patil SB, Hugar S, Patil S. Green teeth associated with hyperbilirubinemia: a case report. European Journal of Paediatric Dentistry. 2014;15(2):221-3.
Neves Silva R. Análise micromorfológica do esmalte e da dentina dos dentes verdes de pacientes portadores de hiperbilirrubinemia [Dissertação]. São Paulo: Universidade Estadual de Campinas. Faculdade de Odontologia de Paranapiacaba. 2013 [acesso em 2020 out. 26]. Disponível em: http://www.repositorio.unicamp.br/handle/REPOSIP/289524.
Shibata T, Watanabe K, Oda H, Arisue M, Kurosawa T, Tohma M, et al. Experimental bilirubin pigmentation of rat dentine and its detection by a qualitative analytical method. Archs Oral Biol. 1996;41(5):509-11.
Sommer S, Magagnin K, Kramer PF, Tovo MF, Bervian J. Green teeth associated with neonatal hyperbilirubinemia caused by biliary atresia: review and case report. J Clin Pediatr Dent. 2010;35(2):199-202.
Fernandes KS, Magalhães M, Ortega KL. Green teeth. J Pediatr. 2011;158(3):510.
Guimarães LP, Silva TA. Green teeth associated with cholestasis caused by sepsis: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(4):446-51.
Watanabe K, Shibata T, Kurosawa T, Morisaki I, Kinehara M, Igarashi S, et al. Bilirubin pigmentation of human teeth caused by hyperbilirubinemia. J Oral Pathol Med. 1999;28:128-30.
Lin YT, Lin YT, Chen CL. A survey of the oral status of children undergoing liver transplantation. Chang Gung Med J. 2003;26:184-8.
Seow WK, Shepherd RW, Ong TH. Oral changes associated with end-stage liver disease and liver transplantation: implications for dental management. ASDC J Dent Child. 1991;58:474-80.
Funakoshi Y, Ohshita C, Moritani Y, Hieda T. Dental findings of patients who underwent liver transplantation. J Clin Pediatr Dent. 1992;16:259-62.
Belanger GK, Sanger R, Casamassimo PS, Bystrom EB. Oral and systemic findings in biliary atresia: report of 11 cases. Pediatric Dentistry. 1982;4(4):322-6.
Amaral THA, Guerra CS, Bombonato-Prado KF, Silva FWGP, Queiroz AM. Tooth pigmentation caused by biilirubin: a case report and histological evaluation. Spec Care Dentist. 2008;28(6):254-7.
Sui T, Ying S, Korsunsky AM, Landini G. X-Ray study of human dental tissues affected by erythroblastosis fetalis. Journal of Dental Research. 2015;94(7):1004-10.
Bimstein E, Magliocca K, Cohen D, Morelli G, Katz J. Hyperbilirubinemic stain: location and extent in dental tissues. J Clin Pediatr Dent. 2011;36(1):75-8.
Seremidi K, Kavvadia K, Tosios K, Pandi-Tsami A. Dental intrinsic green pigmentation from primary to mixed dentition: clinical and histological findings. European Journal of Paediatric Dentistry. 2017;18(2):149-52.
Neves Silva R, Alves FA, Antunes A, Goes MF, Giannini M, Tenório MD, et al. Decreased dentin tubules density and reduced thickness of peritubular dentin in hyperbilirubinemia-related green teeth. J Clin Exp Dent. 2017;9(5):622-8.
Rakauskaite A, Juodzbalys G, Pauza DH, Cicciù M. Green pigmentation in human teeth. A stereomicroscopic study. The Journal of Clinical Pediatric Dentistry. 2014;38(4):355-61.
Kasai M. Treatment of biliary atresia with special reference to hepatic porto-enterostomy and its modifications. Prog Pediatr Surg. 1974;6:5-52.
Carvalho E, Ivantes CA, Bezerra JA. Extrahepatic biliary atresia: current concepts and future directions. J Pediatr. 2007;83(2):105-20.
Hartley JL, Davenport M, Kelly DA. Biliary atresia. Lancet. 2009;374(9702):1704-13.
Ling SC. Congenital cholestatic syndromes: what happens when children grow up? Can J Gastroenterol. 2007;21(11):743-51.
Sheehy EC, Heaton N, Smith P, Roberts GJ. Dental management of children undergoing liver transplantation. American Academy of Pediatric Dentistry. 1999;21(4):273-81.
Silva ARS, Alves FA, Antunes A, Goes MF, Lopes MA. Patterns of demineralization and dentin reactions in radiation-related caries. Caries Res. 2009;43(1):43-9.
Moreira JC. Efeito da intensidade da pigmentação dentária na penetração trans-amelodentinária de peróxido de hidrogênio [Dissertação]. São Paulo: Universidade Estadual Paulista. Faculdade de Odontologia de Araçatuba. 2016 [acesso em 2021 jun. 20]. Disponível em: https://repositorio.unesp.br/handle/11449/141936.
Kao TW, Chou CH, Wang CC, Chou CC, Hu J, Chen WL. Associations between serum total bilirubin levels and functional dependence in the elderly. Intern Med J. 2012;42(11):1199-207.
Vivas APM. Avaliação de manifestações bucais em pacientes pediátricos submetidos ao transplante hepático [dissertação]. São Paulo (SP): Universidade de São Paulo, Faculdade de Odontologia; 2012.
Olczak-Kowalczyk D, Kowalczyk W, Krasuska-Sławińska E, Dądalski M, Kostewicz K, Pawłowska J. Oral health and liver function in children and adolescents with cirrhosis of the liver. Prz Gastroenterol 2014;9(1):24-31.
Miller J. The effect of Bilirubin on tooth development in the rat. Arch Oral Biol. 1960;2:143-50.
Morisaki I, Abek Tong LSM, Kato K, Soble S. Dental findings of children with biliary atresia: report of seven cases. J Dent Child. 1990;57:220–3.
Lascala CA, Costa C, Freitas CF, Arita ES, Ferreira ETT, Chilvarquer I, et al. Fundamentos de odontologia: radiologia odontológica e imaginologia. 2. Ed. São Paulo: Editora Santos; 2013.
Campos PH, Andrade RS, Rojas PJ, Ferreira MCD, Santos TBR, Guaré RO, et al. Avaliação da microdurea do esmalte de dentes decíduos de crianças com paralisia cerebral. Rev Odontol UNESP. 2015;44(1):1-5.
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