[Experimentation and clinical analysis of the interrelationships between dental damage and celiac disease]. / Sperimentazione ed analisi clinica dei rapporti intercorrenti tra il danno dentale e la malattia celiaca.

ABSTRACT

Celiac disease is characterized by gluten-dependent atrophy of the intestinal tufts. Aetiologically the genetic "habitus" of the subject has particular importance and, as rear as the pathogenesis is concerned, many theories, among which the most accredited one is "immunopathological", exist. According to what this last one provides, the cell-mediated immunity component is to be considered the true mediator of intestinal injury, whereas the antibody-mediated component and, in particular, anti-gliadin antibodies (AGA) and anti-endomysium antibodies (EMA), has a particular and pre-eminent diagnostic role. Just from this point of view the celiac disease appeared, with the progress of the studies, to be more and more fleeting, because of growing symptomatologic diversification. It is then interesting to take into account that the celiac disease seems to be able to maintain itself asymptomatic for the greatest part of life, perhaps, forever, configuring the appearance of silent celiac disease and contributing to specify the outline of the above-mentioned celiac "habitus". Recently, besides, close associations have been found between many different diseases and celiac disease. Even for such reasons we relied upon the indication of the ESPGAN in order to achieve a sure and standardized diagnosis of celiac disease. Early diagnosis of celiac disease is very important because it allows a normal psychophysical development and it avoids the strong incidence of lymphomas and other neoplasms of the gastrointestinal tractus which can characterize the natural story of celiac patients. From a more specifically odontological point of view, interesting manifestations exist in the ambit of celiac disease. This last may in fact appear associated particular signs, such as recurrent aphthae or plainly autoimmune diseases with even oral verification. There, however, a more frequent association between celiac disease and some lesions of the tooth enamel which occur in the period of the two stages of histodifferentiation and mineralisation, and they are, respectively, hypoplasias and opacities. Alteration of the enamel, in such stages, both in deciduous and in permanent sets of teeth may be caused by different "noxae"; hence it will be necessary to know how to distinguish between the dental lesions typical of celiac disease and the others. It is helpful the fact that the dental lesion, observed in the course of celiac disease, remembers conceptually the Chronologic Hypoplasia of the enamel. This pathologic form damages the enamel which is depositing, and evolving contemporaneously to the local or systemic "noxa" which is its remote cause.(ABSTRACT TRUNCATED AT 400 WORDS)