Vol 78, No 1 (2019)
Original article
Published online: 2018-06-05
Evaluation of condylar structures on panoramic radiographs in adolescent patients with coeliac disease
Abstract
Background: Coeliac disease (CD) is a common disorder that usually originates from calcium malabsorption. Thus, it is accepted that patients with CD have lo- wer bone mineral density than that of healthy individuals. The aim of this study was to assess condylar height, width, area, and perimeter on digital panoramic radiographs in patients with CD.
Materials and methods: Panoramic radiographs obtained from 44 patients with CD were age- and sex-matched with 44 Class 1 (ANB: 2 ± 2°) patients, and out- comes were analysed. Radiographs were digitised using Image J software, and condylar height, width, area, and perimeter were compared.
Results: Condylar area (3.66 ± 1.02 cm2), perimeter (9.29 ± 1.38 cm), and height (2.69 ± 0.46 cm) values were significantly higher (p < 0.05) in the control group than those in the patient group (area: 2.52 ± 0.63 cm2, perimeter: 8.47 ± 1.42 cm, height: 2.51 ± 0.37 cm), whereas width (coeliac: 2.83 ± 0.63 cm, control: 3.00 ± 0.59 cm) did not differ between the groups (p > 0.05).
Conclusions: These outcomes may be due to the low bone density of patients with CD. A controlled trial conducted using a larger sample is needed to support and extend these data.
Keywords: coeliac diseasemandibular condylepanoramicorthodontics
References
- Aine L, Mäki M, Collin P, et al. Dental enamel defects in celiac disease. J Oral Pathol Med. 1990; 19(6): 241–245.
- Bollen AM, Taguchi A, Hujoel PP, et al. Case-control study on self-reported osteoporotic fractures and mandibular cortical bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 90(4): 518–524.
- Campisi G, Di Liberto C, Carroccio A, et al. Coeliac disease: oral ulcer prevalence, assessment of risk and association with gluten-free diet in children. Dig Liver Dis. 2008; 40(2): 104–107.
- Caraceni MP, Molteni N, Bardella MT, et al. Bone and mineral metabolism in adult celiac disease. Am J Gastroenterol. 1988; 83: 274–277.
- Catassi C, Rätsch IM, Fabiani E, et al. Coeliac disease in the year 2000: exploring the iceberg. Lancet. 1994; 343(8891): 200–203.
- Ciacci C, Cirillo M, Mellone M, et al. Hypocalciuria in overt and subclinical celiac disease. Am J Gastroenterol. 1995; 90(9): 1480–1484.
- de Carvalho FK, de Queiroz AM, Bezerra da Silva RA, et al. Oral aspects in celiac disease children: clinical and dental enamel chemical evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119(6): 636–643.
- Devlin H, Horner K. Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density. Osteoporos Int. 2002; 13(5): 373–378.
- Enlow DH, Moyers RE. Handbook of facial growth. WB Saunders, Philadelphia 1982.
- Exner GU, Sacher M, Shmerling DH, et al. Growth retardation and bone mineral status in children with coeliac disease recognized after the age of 3 years. Helv Paediatr Acta. 1978; 33(6): 497–507.
- Farrell R, Kelly C. Celiac sprue. N Engl J Med. 2002; 346(3): 180–188.
- Fornari MC, Pedreira S, Niveloni S, et al. Pre- and post-treatment serum levels of cytokines IL-1beta, IL-6, and IL-1 receptor antagonist in celiac disease. Are they related to the associated osteopenia? Am J Gastroenterol. 1998; 93(3): 413–418.
- Gemme G, Vignolo M, Naselli A, et al. Linear growth and skeletal maturation in subjects with treated celiac disease. J Pediatr Gastroenterol Nutr. 1999; 29(3): 339–342.
- Horner K, Devlin H, Alsop CW, et al. Mandibular bone mineral density as a predictor of skeletal osteoporosis. Br J Radiol. 1996; 69(827): 1019–1025.
- Kalayci AG, Kansu A, Girgin N, et al. Bone mineral density and importance of a gluten-free diet in patients with celiac disease in childhood. Pediatrics. 2001; 108(5): E89.
- Keaveny AP, Freaney R, McKenna MJ, et al. Bone remodeling indices and secondary hyperparathyroidism in celiac disease. Am J Gastroenterol. 1996; 91(6): 1226–1231.
- Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res. 1994; 102(1): 68–72.
- Kotze LMS, Skare T, Vinholi A, et al. Impact of a gluten-free diet on bone mineral density in celiac patients. Rev Esp Enferm Dig. 2016; 108(2): 84–88.
- Lähteenoja H, Toivanen A, Viander M, et al. Oral mucosal changes in coeliac patients on a gluten-free diet. Eur J Oral Sci. 1998; 106(5): 899–906.
- Mearin ML. Celiac disease among children and adolescents. Curr Probl Pediatr Adolesc Health Care. 2007; 37(3): 86–105.
- Mina S, Riga C, Azcurra AI, et al. Oral ecosystem alterations in celiac children: a follow-up study. Arch Oral Biol. 2012; 57(2): 154–160.
- Molteni N, Caraceni MP, Bardella MT, et al. Bone mineral density in adult celiac patients and the effect of gluten-free diet from childhood. Am J Gastroenterol. 1990; 85(1): 51–53.
- Momjian A, Courvoisier D, Kiliaridis S, et al. Reliability of computational measurement of the condyles on digital panoramic radiographs. Dentomaxillofac Radiol. 2011; 40(7): 444–450.
- Mora S, Barera G, Ricotti A, et al. Reversal of low bone density with a gluten-free diet in children and adolescents with celiac disease. Am J Clin Nutr. 1998; 67(3): 477–481.
- Mora S, Weber G, Barera G, et al. Effect of gluten-free diet on bone mineral content in growing patients with celiac disease. Am J Clin Nutr. 1993; 57(2): 224–228.
- Othman H, Ouda S. Mandibular radiomorphometric measurements as indicators of possible osteoporosis in celiac patients. J King Abdulaziz University-Medical Sciences. 2010; 17(2): 21–35.
- Páez E, Lafuente P, García P, et al. Prevalence of dental enamel defects in celiac patients with deciduous dentition: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(1): 74–78.
- Pritchard L, Lewis SJ, Griffin J, et al. PTU-155 Investigation of the relationship between age, gender, body mass index (BMI) and bone mineral density (BMD) as assessed by dual-energy x-ray absorptiometry (DXA) of the spine and left femur in newly diagnosed patients with coeliac disease (CD). BMJ Publish Group. 2015; 64: A131–A131.
- Smecuol E, Mauriño E, Vazquez H, et al. Gynaecological and obstetric disorders in coeliac disease: frequent clinical onset during pregnancy or the puerperium. Eur J Gastroenterol Hepatol. 1996; 8(1): 63–89.
- Suri L, Gagari E, Vastardis H. Delayed tooth eruption: Pathogenesis, diagnosis, and treatment. A literature review. Am J Orthod Dentofacial Orthop. 2004; 126(4): 432–445.
- Valdimarsson T, Toss G, Ross I, et al. Bone mineral density in coeliac disease. Scand J Gastroenterol. 1994; 29(5): 457–461.
- Vlasiadis KZ, Skouteris CA, Velegrakis GA, et al. Mandibular radiomorphometric measurements as indicators of possible osteoporosis in postmenopausal women. Maturitas. 2007; 58(3): 226–235.
