Disputas: Rønnaug Sæves
Cand.odont. Rønnaug Sæves vil forsvare sin avhandling for graden ph.d.: Prader-Willi syndrome in Norway. Oral aspects
Tid og sted for prøveforelesning
- Professor Anne Skaare, Odontologisk fakultet (komiteens leder)
- Professor Christina Stecksen-Blicks, Umeå universitet (førsteopponent)
- Seksjonsoverlege, professor dr.med. Gunnar Houge, Haukeland sykehus (andreopponent)
- Instituttleder Edvard B. Messelt
- Dr.odont. Kari Storhaug, TAKO-senteret, Lovisenberg diakonale sykehus (hovedveileder)
- Professor Ivar Espelid, Det odontologiske fakultet (medveileder)
- Dr.odont. Hilde Nordgarden, TAKO-senteret, Lovisenberg diakonale sykehus (medveileder)
Prader-Willi syndrome in Norway. Oral aspects
Prader-Willi syndrome (PWS) is a rare complex genetic disorder characterized by hypotonia, endocrine disturbances, hyperphagia and mild mental retardation. Oral abnormalities have not previously been examined systematically and comprehensively in a large group of individuals with PWS.
The over all aim of this study was to further develop understanding and knowledge of oral health and evaluate quantitative and qualitative characteristics of saliva.
The study employed an observational case-control design and fifty individuals aged 5 years and older with a confirmed genetic diagnosis of PWS were examined. A clinical dental examination was carried out. Salivary flow rates were evaluated and whole salivary concentrations of total protein, MUC7 and cystatin were assessed.
The results showed a novel finding of hypodontia in PWS. Whole salivary flow rates were low independent of supplementary diseases or medication. In spite of low salivary flow rate and high gingival index indicating poor oral hygiene, Norwegian individuals with PWS do not have increased caries prevalence.
Our study provides evidence that tooth wear, in terms of both erosion and attrition, is a severe problem in PWS. Tooth grinding was associated with tooth wear. Gastro-oesophageal reflux was identified in some individuals with PWS. The total protein concentration (mg/ml) was significantly higher and MUC7, essential for nearly all functions of saliva, was increased about three-fold in the PWS group compared with the control group. The output (mg/min) of all examined proteins was comparable between PWS and controls, indicating that the fluid and protein secretion mechanisms are differently affected by the condition.
High pain threshold may mask underlying causes of pain and result in pulp exposure before the patient has complained of pain. This should be taken into account when planning examinations and treatment. Tooth wear should be closely followed to evaluate the need for timely restorative treatment.