Introduction: Sickle cell disease is a genetic disorder in which one of the musculoskeletal manifestations is osteonecrosis, which preferentially affects the femoral head. However, damage to the mandibular bone has been reported in the literature. This study aimed to investigate bone changes in the mandible of children with SS sickle cell disease. Method: A case-control study was conducted on 100 children aged 5 to 15 years. Cases were children with SS sickle cell disease and controls were children without sickle cell disease. Bone changes were studied using radiographic variables: radiographic zones, decorticalisation of the mandibular canal, and mandibular cortical index. The Chi2 and Fisher tests were used to compare the distribution of the variables of interest between the groups. Results: The study population was made up of 55% boys and the mean age was 10.01 ± 2.86 years. There was a significant difference in the distribution of the presence of a radiolucent area of the mandibular body (p < 0.001) between the groups (46% versus 2%) and of the apex (p < 0.001) between the groups (54% versus 4%). In addition, almost 1/3 of the children (28%) had a radio-opaque area at the apex (25% versus 3%) and one child in 10 in the sickle cell group had a radio-opaque area of the mandibular body. The distribution of the presence of decortication of the mandibular canal was significantly different (p < 0.001) between cases (54%) and controls (6%). Conclusion: The study revealed significant radiographic bone changes in children with sickle cell disease. Thus, dental radiography may be a diagnostic tool of choice for sickle cell disease in children.
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