The impact of primary hyperparathyroidism on the oral cavity.
BACKGROUND
Primary hyperparathyroidism (HPT) is a systemic disease causing bone loss. Periodontal disease is a local inflammatory disease characterized by alveolar bone loss. The older literature records that HPT is associated with loss of radicular lamina dura and brown tumors of the bone, but contemporary studies are lacking.


OBJECTIVE
The objective of the study was to determine the effects of HPT on oral bony structures and periodontal disease in a contemporary population.


METHODS
This was a cross-sectional, case-controlled study.


METHODS
The study was conducted at the clinics of endocrine surgery and hospital dentistry.


METHODS
Fifty-nine patients, 39 with HPT and 20 thyroid controls, were included in the study.


METHODS
Periodontal clinical measures and dental radiographic analyses were used in this study.


RESULTS
HPT patients were more likely to have tori and reductions in radicular lamina dura on dental radiographs. Widening of the periodontal ligament space surrounding teeth correlated with serum PTH levels. Panoramic radiographs demonstrated reduced cortical bone thickness at the angle of the mandible in HPT patients but no evidence of brown tumors or other overt pathologies.


CONCLUSIONS
Changes in the oral cavity observed in patients with HPT suggested both decreased cortical density and increased likelihood of oral tori. The contemporary oral manifestations of primary HPT are different from those previously reported, and health care providers should be aware of newer, more subtle findings that may be present when treating patients with HPT.
Padbury
Allan D
AD
D.D.S., Department of Periodontics and Oral Medicine, University of Michigan, 1011 North University Avenue, Ann Arbor, Michigan 48109-1078, USA.
Tözüm
Tolga F
TF
Taba
Mario
M
Ealba
Erin L
EL
West
Brady T
BT
Burney
Richard E
RE
Gauger
Paul G
PG
Giannobile
William V
WV
McCauley
Laurie K
LK
D000328:Adult; D000368:Aged; D015519:Bone Density; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010510:Periodontal Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography; D018709:Statistics, Nonparametric; D016388:Tooth Loss / Q000209:etiology
C470125:PTH protein, human; D010281:Parathyroid Hormone; D002118:Calcium