Der Einfluss der Enzymersatztherapie auf die Mundgesundheit bei Hypophosphatasie: Scoping Review

Zusammenfassung

Hintergrund

Hypophosphatasie (HPP) ist eine seltene genetische Erkrankung mit reduzierter Aktivität der gewebeunspezifischen alkalischen Phosphatase (TNALP), die zu gestörter Knochen- und Zahnmineralisation führt. Dieses Review untersucht den Einfluss der Enzymersatztherapie (ERT) mit Asfotase Alfa auf die orale Gesundheit von HPP-Patienten.

Material & Methoden

Eine strukturierte Literaturrecherche in PubMed, Scopus und Web of Science identifizierte Studien, die orale Parameter unter ERT untersuchten. Eingeschlossen wurden Publikationen zu Zahnverlust, Zahndurchbruch, Mineralisationsdefekten und parodontalem Status.

Ergebnisse

Mehrere Studien zeigen, dass die ERT den frühzeitigen Zahnverlust reduziert und den Zahndurchbruch stabilisieren kann. Zudem verbessert sie die Mineralisation von Schmelz, Dentin und Alveolarknochen und führt zu einer festeren Verankerung der Zähne. Eine vollständige Normalisierung des Zahnhalteapparats wird jedoch nicht erreicht. Die Datenlage ist heterogen, randomisierte Studien fehlen.

Schlussfolgerung

Die ERT kann insbesondere bei frühem Therapiebeginn positive Effekte auf die Mundgesundheit von HPP-Patienten bewirken, vor allem durch eine Reduktion des vorzeitigen Zahnverlusts und eine verbesserte Zahnmineralisation. Langzeitstudien sind erforderlich, um die nachhaltigen Effekte auf die dentoalveoläre Gesundheit zu klären.

Abstract

Background

Hypophosphatasia (HPP) is a rare genetic disorder caused by reduced activity of tissue-nonspecific alkaline phosphatase (TNALP), resulting in impaired mineralization of bone and teeth. This review evaluates the impact of enzyme replacement therapy (ERT) with asfotase alfa on the oral health of HPP patients.

Methods

A structured literature search in PubMed, Scopus, and Web of Science identified studies assessing oral outcomes in HPP under ERT. Included were publications addressing tooth loss, eruption, mineralization defects, and periodontal status.

Results

Several studies indicate that ERT reduces premature tooth loss and helps to stabilize tooth eruption. It also improves the mineralization of enamel, dentin, and alveolar bone, leading to enhanced tooth anchorage. Complete normalization of the periodontium, however, is not achieved. The available data are heterogeneous, and randomized controlled trials are lacking.

Conclusion

ERT appears to exert beneficial effects on oral health in HPP, particularly when initiated early. It may reduce premature tooth loss and improve mineralization of dental tissues. Long-term prospective studies are needed to clarify the sustained effects on dentoalveolar structures.

Schlüsselwörter

Hypophosphatasie - Mundgesundheit - Enzymersatztherapie

Keywords

Hypophosphatasia - Oral Health - Enzyme Replacement Therapy

^* These authors contributed equally to the study and share the position as last author.

Publication History

Received: 13 October 2025

Accepted after revision: 20 November 2025

Article published online:
13 February 2026

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