Amaç
Epilepsi hastalarının tedavisinde kullanılan antiepileptik
ilaçlar kemik dokusu üzerinde olumsuz etki yapmaktadır
ancak bildiğimiz kadarı ile bu hastalarda diş
kökü rezorpsiyonu araştırılmamıştır. Bu çalışmanın
amacı, antiepileptik ilaç kullanan epilepsi hastalarında
eksternal ve internal kök rezorpsiyon prevalansını
ve rezorpsiyon bölgelerine göre dağılımını değerlendirmektir.
Gereç ve Yöntem
Diş tedavisi öncesi elde edilen panoramik radyografiler
değerlendirildi. Vaka grubu sadece epilepsili bireylerden
oluşurken, kontrol grubu sağlıklı bireylerden
oluştu. Tüm dişlerde (üçüncü azı dişleri hariç) dış ve
iç rezorpsiyon varlığı/yokluğu, rezorpsiyon bölgesi
(kökün servikal, orta ve apikal bölgesi), yaşı ve cinsiyeti
bir excel dosyasına kaydedildi. Dağılımın normalliğine
göre bağımsız örneklem t-testi veya Mann-Whitney
U testi ve kategorik değişkenleri karşılaştırmak
için ki-kare testi kullanıldı.
Bulgular
424 hastanın (236 sağlıklı birey ve 188 epileptik hasta)
93'ünde (%21,9) rezorpsiyon olduğunu gösterse
de gruplar arasında eksternal ve internal rezorpsiyon
varlığı açısından anlamlı farklılık yoktu (p = 0,089 ve
0,746). Rezorpsiyon 30 yaş üstü ve erkeklerde daha
sıktı (p=0,018 ve 0,013).
Sonuç
Epilepsi hastalarında rezorpsiyon varlığının sağlıklı
deneklerden farklı olmadığı sonucuna vardık. Ancak
epilepsili hastalarda rezorpsiyon en çok alt azı dişleri
ve orta 1/3 bölgede görüldü. Klinisyenler bu hastalarda
diş tedavisi yaparken sonuçlarımızı dikkate almalıdır.
1. Word Health Organization; Epilepsy. [cited 11 March 2024]
Available from: https://www.who.int/news-room/fact-sheets/
detail/epilepsy
2. Dudley RW, Penney SJ, Buckley DJ. First-drug treatment failures
in children newly diagnosed with epilepsy. Pediatr Neurol
2009;40:71-77.
3. Fan HC, Lee HS, Chang KP, et al. The Impact of anti-epileptic
drugs on growth and bone metabolism. Int J Mol Sci
2016;17:1242.
4. Meier C, Kraenzlin ME. Antiepileptics and bone health. Ther
Adv Musculoskelet Dis 2011;3:235-43.
5. Siniscalchi A, Murphy S, Cione E, et al. Antiepileptic drugs
and bone health: Current concepts. Psychopharmacol Bull
2020;50:36-44.
6. Takahashi A, Saito T, Mayanagi H, et al. Effects of the antiepileptics
phenytoin and zonisamide on dentin formation and bone
mineral density of the mandible in growing rats. Methods Find
Exp Clin Pharmacol 2004;26:769-773.
7. Ogunbodede E, Adamolekun B, Akintomide A. Oral health and
dental treatment needs in nigerian patients with epilepsy. Epilepsia
1998;39:590-594.
8. Shaw MJ, Shaw L, Foster TD. The oral health in different groups
of adults with mental handicaps attending Birmingham (UK)
adult training centres. Community Dent Health 1990;7:135-141.
9. Károlyházy K, Kovács E, Kivovics P, et al. Dental status and
oral health of patients with epilepsy: An epidemiologic study.
Epilepsia 2003;44:1103-1108.
10. Galas-Zgorzalewicz B, Borysewicz-Lewicka M, Zgorzalewicz
M, et al. The effect of chronic carbamazepine, valproic acid and
phenytoin medication on the periodontal condition of epileptic
children and adolescents. Funct Neurol 1996;11:187-193.
11. Dahllof G, Preber H, Eliasson S, et al. Periodontal condition of
epileptic adults treated long‐term with phenytoin or carbamazepine.
Epilepsia 1993;34:960-964.
12. Endodontists AAO. Glossary of endodontic terms: American
Association of Endodontists; 2003.
13. Trope M. Cervical root resorption. J Am Dent Assoc
1997;128:56S-59S.
14. Tronstad L. Root resorption-etiology, terminology and clinical
manifestations. Dent Traumatol 1988;4:241-252.
15. Fuss Z, Tsesis I, Lin S. Root resorption–diagnosis, classification
and treatment choices based on stimulation factors. Dent
Traumatol 2003;19:175-182.
16. Patel S, Saberi N. The ins and outs of root resorption. Br Dent
J 2018;224:691-699.
17. Patel S, Kanagasingam S, Ford TP. External cervical resorption:
a review. J Endod 2009;35:616-625.
18. Saccomanno S, Passarelli PC, Oliva B, et al. Comparison between
two radiological methods for assessment of tooth root resorption:
An in vitro study. Biomed Res Int 2018;2018:5152172.
19. Dudic A, Giannopoulou C, Leuzinger M, et al. Detection of
apical root resorption after orthodontic treatment by using
panoramic radiography and cone-beam computed tomography
of super-high resolution. Am J Orthod Dentofacial Orthop
2009;135:434-437.
20. Lima T, Gamba TdO, Zaia AA, et al. Evaluation of cone beam
computed tomography and periapical radiography in the diagnosis
of root resorption. Aust Dent J 2016;61:425-431.
21. Rahmel S, Schulze RK. Accuracy in detecting artificial root resorption
in panoramic radiography versus tomosynthetic panoramic
radiographs. J Endod 2019;45:634-639.
22. Kweon HH, Lee JH, Youk TM, et al. Panoramic radiography can
be an effective diagnostic tool adjunctive to oral examinations
in the national health checkup program. J Periodontal Implant
Sci 2018;48:317-325.
23. Svenson B, Ståhlnacke K, Karlsson R, et al. Dentists’ use of
digital radiographic techniques: Part ii–extraoral radiography: A
questionnaire study of swedish dentists. Acta Odontol Scand
2019;77:150-57.
24. Snel R, Van De Maele E, Politis C, et al. Digital dental radiology
in belgium: A nationwide survey. Dentomaxillofac Radiol
2018;47:20180045.
25. Soares AJ, Souza GA, Pereira AC, et al. Frequency of root
resorption following trauma to permanent teeth. J Oral Sci
2015;57:73-78.
26. Consensus development conference: Diagnosis, prophylaxis,
and treatment of osteoporosis. Am J Med 1993;94:646-50.
27. Tsesis I, Fuss Z, Rosenberg E, et al. Radiographic evaluation
of the prevalence of root resorption in a Middle Eastern population.
Quintessence Int 2008;39(2):40-44.
28. Mikušková K, Vaňuga P, Adamicová K, et al. Multiple idiopathic
external cervical root resorption in patient treated continuously
with denosumab: a case report. BMC Oral Health 2022;22:129.
29. Dobroś K, Myciński P, Borowy P, et al. Multiple invasive cervical
resorption and celiac disease: A case report. Quintessence Int
2018;49:407-412.
30. Patel S, Saberi N. External cervical resorption associated
with the use of bisphosphonates: A case series. J Endod
2015;41:742-748.
31. Alyahya L, Myers GL. Denosumab use as a predictor variable
for external cervical resorption: A case-control study. J Endod
2021;47:366-373.
32. Marinescu IR, Bănică AC, Mercuţ V, et al. Root resorption diagnostic:
role of digital panoramic radiography. Curr Health Sci J
2019;45:156-166.
33. Landis JR, Koch GG. The measurement of observer agreement
for categorical data. Biometrics 1977;33:159-174.
34. McNab S, Battistutta D, Taverne A, et al. External apical root
resorption of posterior teeth in asthmatics after orthodontic treatment.
Am J Orthod Dentofacial Orthop 1999;116:545-551.
35. Irinakis E, Aleksejuniene J, Shen Y, et al. External cervical
resorption: A retrospective case-control study. J Endod
2020;46:1420-1427.
36. Dao V, Mallya SM, Markovic D, et al. Prevalence and characteristics
of root resorption identified in cone-beam computed
tomography scans. J Endod 2023;49:144-154.
37. Bănică AC, Marinescu IR, Gheorghe DN, et al. Root resorption
prevalence in adults from dolj county, Romania–a radiological
evidence. Romanian Journal of Oral Rehabilitation
2018;10:170-179
38. Laux M, Abbott PV, Pajarola G, et al. Apical inflammatory root
resorption: A correlative radiographic and histological assessment.
Int Endod J 2000;33:483-493.
39. Aydın Ü, Aybar Y. Panoramik radyografilerde ortaya çıkan hataların
tipleri ve sıklığı. SDÜ Tıp Fak Derg 2004;11:2.
40. Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption:
A three-dimensional classification. Int Endod J
2018;51:206-214.
41. Futyma-Gąbka K, Różyło-Kalinowska I, Piskórz M, et al. Evaluation
of root resorption in maxillary anterior teeth during orthodontic
treatment with a fixed appliance based on panoramic
radiographs. Pol J Radiol 2022;87:545-548.
42. Sirisoontorn I, Hotokezaka H, Hashimoto M, et al. Tooth movement
and root resorption; the effect of ovariectomy on orthodontic
force application in rats. Angle Orthod 2011;81:570-577.
43. Griepp DW, Kim DJ, Ganz M, et al. The effects of antiepileptic
drugs on bone health: A systematic review. Epilepsy Res
2021;173:106619.
118
RADIOLOGICAL ASSESSMENT OF THE PREVALENCE AND LOCATION OF ROOT RESORPTION IN EPILEPTIC PATIENTS: AN OBSERVATIONAL STUDY
Year 2024,
Volume: 31 Issue: 1, 111 - 118, 18.03.2024
Objective
Antiepileptic drugs used in the treatment of epilepsy
patients have a negative effect on bone tissue, but as far as we know, tooth root resorption has not been
investigated in these patients. The aim of this study was
to evaluate the prevalence of external and internal root
resorption and its distribution according to resorption
sites in epilepsy patients using antiepileptic drugs.
Material and Method
Panoramic radiographs obtained before dental
treatment were evaluated. While the case group
consisted of only those with epilepsy, the control group
included healthy subjects. The presence/absence of
external and internal resorption of all teeth (except the
third molars), region of resorption (cervical, middle, and
apical region of the root), age, and sex were recorded
in an excel file. Independent sample t-test or Mann-
Whitney U test according to normality of distribution
and a chi-square test to compare categorical variables
were used.
Results
The resorption in 93 (21.9%) of 424 patients (236
healthy subjects and 188 epileptic patients), the groups
did not significantly differ by the presence of external
and internal resorption (p = 0.089 and 0.746). It was
more common in those over 30 years and males (p =
0.018 and 0.013).
Conclusion
We concluded that the presence of resorption in
epilepsy patients was not different from healthy
subjects. However, in patients with epilepsy, resorption
was mostly seen in the lower molars and middle 1/3
regions. Clinicians should consider our results when
treating these patients.
1. Word Health Organization; Epilepsy. [cited 11 March 2024]
Available from: https://www.who.int/news-room/fact-sheets/
detail/epilepsy
2. Dudley RW, Penney SJ, Buckley DJ. First-drug treatment failures
in children newly diagnosed with epilepsy. Pediatr Neurol
2009;40:71-77.
3. Fan HC, Lee HS, Chang KP, et al. The Impact of anti-epileptic
drugs on growth and bone metabolism. Int J Mol Sci
2016;17:1242.
4. Meier C, Kraenzlin ME. Antiepileptics and bone health. Ther
Adv Musculoskelet Dis 2011;3:235-43.
5. Siniscalchi A, Murphy S, Cione E, et al. Antiepileptic drugs
and bone health: Current concepts. Psychopharmacol Bull
2020;50:36-44.
6. Takahashi A, Saito T, Mayanagi H, et al. Effects of the antiepileptics
phenytoin and zonisamide on dentin formation and bone
mineral density of the mandible in growing rats. Methods Find
Exp Clin Pharmacol 2004;26:769-773.
7. Ogunbodede E, Adamolekun B, Akintomide A. Oral health and
dental treatment needs in nigerian patients with epilepsy. Epilepsia
1998;39:590-594.
8. Shaw MJ, Shaw L, Foster TD. The oral health in different groups
of adults with mental handicaps attending Birmingham (UK)
adult training centres. Community Dent Health 1990;7:135-141.
9. Károlyházy K, Kovács E, Kivovics P, et al. Dental status and
oral health of patients with epilepsy: An epidemiologic study.
Epilepsia 2003;44:1103-1108.
10. Galas-Zgorzalewicz B, Borysewicz-Lewicka M, Zgorzalewicz
M, et al. The effect of chronic carbamazepine, valproic acid and
phenytoin medication on the periodontal condition of epileptic
children and adolescents. Funct Neurol 1996;11:187-193.
11. Dahllof G, Preber H, Eliasson S, et al. Periodontal condition of
epileptic adults treated long‐term with phenytoin or carbamazepine.
Epilepsia 1993;34:960-964.
12. Endodontists AAO. Glossary of endodontic terms: American
Association of Endodontists; 2003.
13. Trope M. Cervical root resorption. J Am Dent Assoc
1997;128:56S-59S.
14. Tronstad L. Root resorption-etiology, terminology and clinical
manifestations. Dent Traumatol 1988;4:241-252.
15. Fuss Z, Tsesis I, Lin S. Root resorption–diagnosis, classification
and treatment choices based on stimulation factors. Dent
Traumatol 2003;19:175-182.
16. Patel S, Saberi N. The ins and outs of root resorption. Br Dent
J 2018;224:691-699.
17. Patel S, Kanagasingam S, Ford TP. External cervical resorption:
a review. J Endod 2009;35:616-625.
18. Saccomanno S, Passarelli PC, Oliva B, et al. Comparison between
two radiological methods for assessment of tooth root resorption:
An in vitro study. Biomed Res Int 2018;2018:5152172.
19. Dudic A, Giannopoulou C, Leuzinger M, et al. Detection of
apical root resorption after orthodontic treatment by using
panoramic radiography and cone-beam computed tomography
of super-high resolution. Am J Orthod Dentofacial Orthop
2009;135:434-437.
20. Lima T, Gamba TdO, Zaia AA, et al. Evaluation of cone beam
computed tomography and periapical radiography in the diagnosis
of root resorption. Aust Dent J 2016;61:425-431.
21. Rahmel S, Schulze RK. Accuracy in detecting artificial root resorption
in panoramic radiography versus tomosynthetic panoramic
radiographs. J Endod 2019;45:634-639.
22. Kweon HH, Lee JH, Youk TM, et al. Panoramic radiography can
be an effective diagnostic tool adjunctive to oral examinations
in the national health checkup program. J Periodontal Implant
Sci 2018;48:317-325.
23. Svenson B, Ståhlnacke K, Karlsson R, et al. Dentists’ use of
digital radiographic techniques: Part ii–extraoral radiography: A
questionnaire study of swedish dentists. Acta Odontol Scand
2019;77:150-57.
24. Snel R, Van De Maele E, Politis C, et al. Digital dental radiology
in belgium: A nationwide survey. Dentomaxillofac Radiol
2018;47:20180045.
25. Soares AJ, Souza GA, Pereira AC, et al. Frequency of root
resorption following trauma to permanent teeth. J Oral Sci
2015;57:73-78.
26. Consensus development conference: Diagnosis, prophylaxis,
and treatment of osteoporosis. Am J Med 1993;94:646-50.
27. Tsesis I, Fuss Z, Rosenberg E, et al. Radiographic evaluation
of the prevalence of root resorption in a Middle Eastern population.
Quintessence Int 2008;39(2):40-44.
28. Mikušková K, Vaňuga P, Adamicová K, et al. Multiple idiopathic
external cervical root resorption in patient treated continuously
with denosumab: a case report. BMC Oral Health 2022;22:129.
29. Dobroś K, Myciński P, Borowy P, et al. Multiple invasive cervical
resorption and celiac disease: A case report. Quintessence Int
2018;49:407-412.
30. Patel S, Saberi N. External cervical resorption associated
with the use of bisphosphonates: A case series. J Endod
2015;41:742-748.
31. Alyahya L, Myers GL. Denosumab use as a predictor variable
for external cervical resorption: A case-control study. J Endod
2021;47:366-373.
32. Marinescu IR, Bănică AC, Mercuţ V, et al. Root resorption diagnostic:
role of digital panoramic radiography. Curr Health Sci J
2019;45:156-166.
33. Landis JR, Koch GG. The measurement of observer agreement
for categorical data. Biometrics 1977;33:159-174.
34. McNab S, Battistutta D, Taverne A, et al. External apical root
resorption of posterior teeth in asthmatics after orthodontic treatment.
Am J Orthod Dentofacial Orthop 1999;116:545-551.
35. Irinakis E, Aleksejuniene J, Shen Y, et al. External cervical
resorption: A retrospective case-control study. J Endod
2020;46:1420-1427.
36. Dao V, Mallya SM, Markovic D, et al. Prevalence and characteristics
of root resorption identified in cone-beam computed
tomography scans. J Endod 2023;49:144-154.
37. Bănică AC, Marinescu IR, Gheorghe DN, et al. Root resorption
prevalence in adults from dolj county, Romania–a radiological
evidence. Romanian Journal of Oral Rehabilitation
2018;10:170-179
38. Laux M, Abbott PV, Pajarola G, et al. Apical inflammatory root
resorption: A correlative radiographic and histological assessment.
Int Endod J 2000;33:483-493.
39. Aydın Ü, Aybar Y. Panoramik radyografilerde ortaya çıkan hataların
tipleri ve sıklığı. SDÜ Tıp Fak Derg 2004;11:2.
40. Patel S, Foschi F, Mannocci F, Patel K. External cervical resorption:
A three-dimensional classification. Int Endod J
2018;51:206-214.
41. Futyma-Gąbka K, Różyło-Kalinowska I, Piskórz M, et al. Evaluation
of root resorption in maxillary anterior teeth during orthodontic
treatment with a fixed appliance based on panoramic
radiographs. Pol J Radiol 2022;87:545-548.
42. Sirisoontorn I, Hotokezaka H, Hashimoto M, et al. Tooth movement
and root resorption; the effect of ovariectomy on orthodontic
force application in rats. Angle Orthod 2011;81:570-577.
43. Griepp DW, Kim DJ, Ganz M, et al. The effects of antiepileptic
drugs on bone health: A systematic review. Epilepsy Res
2021;173:106619.
118
Temur KT, Pertek Hatipoğlu F, Mağat G. RADIOLOGICAL ASSESSMENT OF THE PREVALENCE AND LOCATION OF ROOT RESORPTION IN EPILEPTIC PATIENTS: AN OBSERVATIONAL STUDY. Med J SDU. 2024;31(1):111-8.