Oro-mandibular manifestations of primary hyperparathyroidism.
OBJECTIVE
To determine the effects of Primary Hyperparathyroidism on oral cavity in a symptomatic contemporary Indian population by taking note of the following parameters: (1) Radiological alteration of lamina dura, (2) mandibular cortical width, (3) prevalence of brown tumor, and (4) mandibular tori.


METHODS
Twenty-six patients of Primary Hyperparathyroidism were examined clinically and radiologically for extra- and intraoral abnormalities. Loss of lamina dura, mandibular cortical width, presence of mandibular tori, and brown tumors were assessed and correlated with serum Calcium, Phosphate, Parathormone, and Alkaline phosphatase. The results were compared with twenty-six age- and gender-matched control subjects. The data was expressed as mean ± SD, and a probability (p) value of < 0.05 was considered significant. Pearson's statistical method was used to assess the significant correlation between radiological measurements and biochemical values.


RESULTS
Generalized absence of the lamina dura was the most consistent finding and there was a significant correlation between its loss and altered parathormone, alkaline phosphatase, and inorganic phosphate, but not with serum calcium or the duration of the disease. Mean values (in mm) for the cortical indices were significantly lower in the patients compared to the controls and correlated significantly with parathormone and alkaline phosphatase. None of the patients had mandibular tori and only one patient had a brown tumor.


CONCLUSIONS
Loss of lamina dura, ground glass appearance, and mandibular cortical width reduction are common findings in primary hyperparathyroidism and these are significantly correlated with elevated parathormone and alkaline phosphatase. However, the presence of brown tumors and oral tori are less commonly encountered features.
Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Sachin
S
Rai
Sanjay K
SK
Bhadada
Vidya
V
Rattan
Anil
A
Bhansali
D S
DS
Rao
Viral
V
Shah
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D005096:Exostoses / Q000209:etiology; D005260:Female; D006101:Granuloma, Giant Cell / Q000209:etiology; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D009059:Mouth Diseases / Q000209:etiology*; D010002:Osteitis Fibrosa Cystica / Q000209:etiology; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D016300:Radiography, Bitewing; D011862:Radiography, Panoramic
D010281:Parathyroid Hormone; D010710:Phosphates; D000469:Alkaline Phosphatase; D002118:Calcium