くる病と歯科疾患

Updates on Rickets and Osteomalacia. Dental diseases in rickets.

　くる病は骨・軟骨の石灰化障害を特徴とする疾患で，遺伝性くる病の中で最も頻度が高いのがＸ連鎖性低リン血症性くる病（XLH）である。XLHの歯の象牙質において骨・軟骨と同様に石灰化障害が認められる。外傷や齲歯がなく一見健全に見える乳歯や永久歯に，根尖周囲膿瘍が認められることがある。日常の口腔内衛生管理，定期的な歯科的診察が重要で，予防的に咬合面へのシーラント剤の被覆を行うことがある。根尖周囲膿瘍に対して，歯内療法や抜歯が行われる。XLHの歯における石灰化障害や膿瘍発生の機序の解明，根尖周囲膿瘍の予防や治療に対する更なる研究が望まれる。

　Rickets is characterized by mineralization defect in bone and cartilage. X-linked hypophosphatemic rickets（XLH）is the most common form of inherited rickets. Mineralization defect is observed in dentin as well as in bone and cartilage in XLH. The dominant feature is the occurrence of infectious periradicular abscesses on deciduous and permanent teeth, not associated with trauma or decay. Dental care including the maintenance of good oral hygiene and periodical examinations should be performed. A preventive sealing of occlusal surfaces can be considered. Endodontic treatment or extraction are carried out in the presence of periradicular abscesses. Further studies are necessary for elucidating mechanisms of dentin mineralization defect and the occurrence of periradicular abscesses and for developing preventive and curative measures in XLH.