Severe periodontitis in a patient with hyperoxaluria and oxalosis: a case report and review of the literature.
BACKGROUND
Hyperoxaluria is a metabolic disease with excessive urinary oxalate excretion that can be primary or secondary. Hyperoxaluria can result in chronic renal disease and renal failure. Calcium oxalate crystals can be deposited in oral tissues, and the disease can be associated with severe periodontitis and tooth loss.


METHODS
The periodontal condition of a 38-year-old patient with a diagnosis of hyperoxaluria and end-stage renal disease is presented. The patient's periodontal status was monitored over a period of several weeks, and extracted teeth were submitted for histopathologic evaluation.


RESULTS
The patient was diagnosed with generalized severe periodontitis and external root resorption. Initial periodontal treatment consisting of oral-hygiene instructions and scaling and root planing was performed. However, despite an initial decrease of soft tissue inflammation, the patient's periodontal condition deteriorated, and eventually, all teeth had to be extracted. The deposition of calcium oxalate crystals in the periodontal tissues was confirmed histologically.


CONCLUSIONS
Long-standing hyperoxaluria can be associated with severe periodontitis and external root resorption resulting in tooth loss. The pathogenetic mechanisms of hard tissue destruction are still unclear.
Panis
Vassilios
V
Department of Periodontology, School of Dentistry, National and Kapodestrian University of Athens, Athens, Greece. vpanis@dent.uoa.gr
Tosios
Konstantinos I
KI
Gagari
Eleni
E
Griffin
Terrence J
TJ
Damoulis
Petros D
PD
D000328:Adult; D002129:Calcium Oxalate / Q000378:metabolism*; D018450:Disease Progression; D006801:Humans; D006960:Hyperoxaluria, Primary / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male; D010518:Periodontitis / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D012391:Root Resorption / Q000209:etiology; D016388:Tooth Loss / Q000209:etiology
D002129:Calcium Oxalate