ORAL MANIFESTATIONS OF HYPERPARATHYROIDISM: PITFALLS IN DENTAL MANAGEMENT

Authors: Letiția LEUȘTEAN, Maria Christina UNGUREANU, Laura TEODORIU, Alexandru GRIGOROVICI, Delia BAHRIM, Carmen STADOLEANU

Abstract:

Hyperparathyroidism (HPT) is a disease characterized by excessive secretion of parathyroid hormone (PTH). In patients with HPT, the chronically increased PTH levels lead to bone loss, osteoporosis and fragility fractures. Bone disease in severe HPT is described classically as osteitis fibrosa cystica. Bone pain, skeletal deformities and pathological fractures are the main manifestations of HPT. The radiologic features of HPT include generalized radiolucency or oval-round radiolucent areas. The most frequent oral clinical manifestations of HPT are: brown tumor, loss of bone density, mobile teeth, drifting of teeth, complaint of vague jaw bone pain, sensitive teeth in mastication and percussion, soft tissue calcifications and dental abnormalities, such as development defects and alterations in dental eruption. Dental management of patients with HPT requires special consideration and precaution regarding surgical treatments. Careful assessment of all radiographic, biochemical and histopathological parameters of patients with HPT by an interdisciplinary team is necessary, in order to establish the surveillance and treatment plan.

Keywords:
  • brown tumor
  • epulis
  • hyperparathyroidism
  • oral tori