Gorham's disease of the mandible mimicking periodontal disease on radiograph.
BACKGROUND
Gorham's disease is a rare disorder characterized by spontaneous and progressive osteolysis of one or more skeletal bones. The radiographic findings associated with Gorham's disease are particularly dramatic, as in some cases a complete resorption of the involved bone can occur, leading to the definition of phantom bone, vanishing bone, or disappearing bone disease.


METHODS
A 24-year-old female patient with a previous diagnosis of periodontal disease and progressive mandibular alveolar bone loss was referred to our Oral Medicine section. The initial radiographic picture showed infrabony defects and horizontal bone loss.


RESULTS
After further extensive local and systemic evaluation, including histopathological, laboratory and imagine techniques investigations, the patient was diagnosed to be affected by Gorham's disease. Meanwhile the progression of the osteolytic process had caused the loosening of all the left mandibular teeth and a pathologic fracture. Appropriate medical therapy was successful in stabilizating the resorptive process, with no evidence of further progressive disease.


CONCLUSIONS
When Gorham's disease involves the mandible, the role of the periodontologist is extremely important in diagnosing promptly the disorder and preventing the functional and aesthetic consequences of advanced and extensive bone loss. Gorham's disease should be included among the pathologic entities mimicking periodontal disease on radiograph, such as inflammatory disease (e.g. osteomyelitis), endocrine disease (e.g. hyperparathyroidism), intra-osseous malignancies or metastases, lymphoma, histiocytosis X, mainly eosinophilic granuloma, infective process (e.g. tuberculosis and actinomycosis), odontogenic tumours.
Mignogna
Michele Davide
MD
Department of Odontostomatological and Maxillofacial Sciences, Section of Oral Medicine, University Federico II, Naples, Italy. mdmig@tin.it
Fedele
Stefano
S
Lo Russo
Lucio
L
Lanza
Alessandro
A
Marenzi
Gaetano
G
Sammartino
Gilberto
G
D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008336:Mandibular Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010015:Osteolysis, Essential / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D000077211:Zoledronic Acid
D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid