Evaluation of Immunological and Biochemical Background for the Occurrence of Dental Caries in B-Thalassemic Patients

Mohammed et al / evaluation of immunological and biochemical background Thalassemia is a hereditary disorder. It leads to decrease production and increase destruction of red blood cells. Several biochemical and immunological alterations seen in those patients that enhance dental caries occurrence and determine severity.To evaluate immunological & biochemical background in thalassemic patients, in relation to dental caries.This is a case control study, that'sdone by descriptive-analyticmethod,in a period between (October 2016 till June 2017), which includes; a total of 56 patients suffering from ß-thalassemia major (age rang 4-22)years, referring to Maternity and Children Hospital in Babylon province, AL-Hilla cityand 32 healthy control (age range 3-22) year. ,DMFT/dmft indicator examined in both groups and serum " IL-6, IL-8,IL-17, Ca++, Mg++, P, Vit.D3" & salivary IgA was assessed in both groups. Caries Experience Examinationshows dmft value is higher in study group (6.82 ± 3.24) than in the control group is (2.43 ± 0.85) with statistically significant differences (p<0.05), DMFT is higher in study group (5.57 ± 2.51) compared to control group (2.79 ± 1.06) which is significant differences statistically (p<0.05). Immunological evaluation of salivary IgA value shows Mean ± S.D of study group lower than control group and the differences is highly statistically significant (P<0.001). Also, immunological evaluation of serum proteins including "IL-6, IL-8, andIL-17. "Mean ± S.D of IL-6 value for study group is higher than for control group, andthere is difference between two groups which is significant statistically (P<0.05), while Mean ± S.D of IL-8 and IL-17 is higher in study group compered to control group, but not significant statistically. While biochemical evaluation of serum minerals constituents include, " Ca++, Mg++, P, and Vit.D3" Mean ± S.D of Vit.D3& Mg++ in study group lower than control group with significant statistically differences between them (P<0.05). Concerning P,Mean ± S.D for study group lower than control group with highly significant differences (P<00.1). Regarding Ca++ Mean ± S.D for study group lower than control group but not significant statistically (P>0.05). There is considerable increment in incidence of dental caries in Thalassemic patients.This increase incidence of dental caries might be due to alterations in the salivary level of IgA, changes in the serum values of minerals " Ca++, Mg++, P, and Vit.D3" , while changes in the serum values of "IL-6, IL-8, and IL17"might due to immunological alterations in thalassemic patients. INTRODUCTION Thalassemia is a type of hemolytic anemia, which includes defects in the synthesis of hemoglobin αor β-polypeptide chains (αand β-thalassemia, respectively). ‟It causes decrease in the production of hemoglobin, which results in anemia of hypochromic microcytic typeassociated with dysplasia and damage of erythrocyte. Thalassemia major commonly appears during early infancy and is a life threatening disease, which results insevere anemia, which is progressive pallor and failure to thrive, are common. The manifestations of thalassemia major areskeletal and craniofacial deformities”. (Hattab, 2013). In relation to oral health, Thalassemia is associated with increased dental caries (Al-Jobouri, 2011). Is a multifactorial human disease (Devi, 2009), in which acids produced by bacteria dissolve the enamel surface of a tooth, that result in localized demineralization of the inorganic components and destruction of organic constituents of the tooth, beginning on the external surfaces. (Hiratsuka, 2013). There are few studies concerning occurrence of dental caries in patients withβThalassemia major, their conclusion is the occurrence and rigorousness of this disease is greater in those patients than in standard controls (Al-Jobouri, 2007; Al-Raheem, et al., 2009). Previous researches found higher incidence oftooth caries and periodontal diseases in thalassemia patients. (Al-Wahadni, et al., 2002). The superiority of life for thalassemic patients' improved by blood transfusion and iron chelation therapy. However, this has led todevelopment of many problems such as immunological changes triggering high infection level. (Kadam, et al., 2014). Therefore, this study designed to study the immunological background and concentration of mineral constituents of the blood to evaluate their role in the development of dental caries in Thalassemic patients.