Oral Clinicocytological Manifestation of Sickle Cell Anemia in Sudanese Patients

Objectives: The aim of this case-control study conducted at the Children Emergency Hospital, at Khartoum city was to detect oral lesions, and to quantify the risk for oral cytological atypia, if any, in children with sickle cell anemia. Methods:  One -hundred cases with sickle cell anemia, and one-hundred controls were examined clinically, and exfoliated cells were taken randomly from the buccal mucosa of some of the patients and controls. The collected data was analyzed. Results: Results showed increased risks of maxillary bone overgrowth, enamel hypoplasia, and an oral ulceration among the cases compared to the controls. Features of cytological atypia were also detected. The study couldn't document increased risks for osteomylitis of the jaw and/or avascular necrosis of the temeromandibular joint in association with sickle cell anemia compared to the controls. The maxillary bone overgrowth was believed to be due to bone marrow hypertrophy, resulting from haemolysis. Where as enamel hypoplasia was explained by the adverse effects of the disease on the amelogensis. The occurance of oral ulcerations among cases with sickle cell anaemia was believed to be due to defective control mechanisms as a result of defective opsonization and Splenic hypofunction. The oral cytological atypia detected was partially explained by the presence of defective cell-mediated immunity. These changes detected, though not different from normal oral pathologies, yet they require special care during treatment of oral problems owing to the general systemic condition of the patient. Conclusion: The oral cytological atypia detected, require further investigations in order to document an in-depth interpretation on the relationship of oral cytological atypia to oral lesions in sickle cell anemia. Finally further studies are needed to provide more information on the causal link between sickle cell and the oral health.