Phosphate and Vitamin D Prevent Periodontitis in X-Linked Hypophosphatemia.
X-linked hypophosphatemia (XLH) is a rare genetic skeletal disease where increased phosphate wasting in the kidney leads to hypophosphatemia and prevents normal mineralization of bone and dentin. Here, we examined the periodontal status of 34 adults with XLH and separated them according to the treatment they received for hypophosphatemia. We observed that periodontitis frequency and severity were increased in adults with XLH and that the severity varied according to the hypophosphatemia treatment. Patients who benefited from an early and continuous vitamin D and phosphate supplementation during their childhood presented less periodontal attachment loss than patients with late or incomplete supplementation. Continued hypophosphatemia treatment during adulthood further improved the periodontal health. Extracted teeth from patients with late or incomplete supplementation showed a strong acellular cementum hypoplasia when compared with age-matched healthy controls. These results show that XLH disturbs not only bone and dentin formation but also cementum and that the constitutional defect of the attachment apparatus is associated with attachment loss.
1 Service d'Odontologie, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France.|2 Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France.|3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.
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Biosse Duplan
4 EA 2496, Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France.
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Coyac
4 EA 2496, Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France.
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Bardet
1 Service d'Odontologie, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France.|2 Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France.
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Zadikian
3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.|5 Service d'endocrinologie, Hôpital Bicêtre, HUPS, AP-HP, Le Kremlin Bicêtre, France.
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Rothenbuhler
3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.|5 Service d'endocrinologie, Hôpital Bicêtre, HUPS, AP-HP, Le Kremlin Bicêtre, France.
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Kamenicky
3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.|6 Service de Rhumatologie, Hôpital Cochin, HUPC, AP-HP, Paris, France.
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Briot
3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.|5 Service d'endocrinologie, Hôpital Bicêtre, HUPS, AP-HP, Le Kremlin Bicêtre, France.
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Linglart
1 Service d'Odontologie, Hôpital Bretonneau, HUPNVS, AP-HP, Paris, France.|3 Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Plateforme d'expertise Paris Sud Maladies rares, filière OSCAR, Hôpital Bicêtre-Paris Sud, AP-HP, Le Kremlin Bicêtre, France.|4 EA 2496, Faculté de Chirurgie Dentaire, Université Paris Descartes, Montrouge, France.
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Chaussain
D000328:Adult; D016022:Case-Control Studies; D053098:Familial Hypophosphatemic Rickets / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D010710:Phosphates / Q000627:therapeutic use*; D011446:Prospective Studies; D011862:Radiography, Panoramic; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use*
D010710:Phosphates; D014807:Vitamin D
alveolar bone loss; dental cementum; hypophosphatemic rickets; osteomalacia; periodontal attachment loss; periodontal disease