title: Implications of gluten exposure period, CD clinical forms, and HLA typing in the association between celiac disease and dental enamel defects in children. A case-control study.
abstract: BACKGROUND
  The association between coeliac disease (CD) and dental enamel defects (DED) is well known.
  
  
  OBJECTIVE
  The aim of this study was to investigate the prevalence of DED in children with CD and to specifically find the association of DED and gluten exposure period, CD clinical forms, HLA class II haplotype.
  
  
  METHODS
  This study was designed as a matched case-control study: 250 children were enrolled (125 coeliac children - 79 female and 46 male, 7.2 +/- 2.8 years and 125 healthy children). Data about age at CD diagnosis, CD clinical form, and HLA haplotype were recorded.
  
  
  RESULTS
  Dental enamel defects were detected in 58 coeliac subjects (46.4%) against seven (5.6%) controls (P < 0.005). We found an association between DED and gluten exposure period, as among CD subjects the mean age at CD diagnosis was significantly (P = 0.0004) higher in the group with DED (3.41 +/- 1.27) than without DED (1.26 +/- 0.7). DED resulted more frequent (100%) in atypical and silent CD forms than in the typical one (30.93%). The presence of HLA DR 52-53 and DQ7antigens significantly increased the risk of DED (P = 0.0017) in coeliac children.
  
  
  CONCLUSIONS
  Our results confirmed a possible correlation between HLA antigens and DED.
authors.affiliation: Dental Clinic, University of Brescia, Brescia.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Majorana
authors.forename: Elena
authors.initials: E
authors.lastname: Bardellini
authors.forename: Alberto
authors.initials: A
authors.lastname: Ravelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Plebani
authors.forename: Antonella
authors.initials: A
authors.lastname: Polimeni
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Campus
mesh_terms: D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000235:genetics / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003743:Dental Enamel / Q000473:pathology*; D003744:Dental Enamel Hypoplasia / Q000209:etiology* / Q000235:genetics / Q000276:immunology; D005260:Female; D005983:Glutens / Q000009:adverse effects*; D006683:HLA-DQ Antigens / Q000235:genetics*; D006684:HLA-DR Antigens / Q000235:genetics*; D006239:Haplotypes; D006801:Humans; D008297:Male; D016017:Odds Ratio; D013997:Time Factors; D014075:Tooth Discoloration / Q000209:etiology
chemical_list: D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D005983:Glutens