Oral and maxillofacial manifestations of chronic kidney disease–mineral and bone disorder: a multicenter retrospective study

Pontes, Flávia Sirotheau Corrêa; Lopes, Márcio Ajudarte; Souza, Lucas Lacerda de; Rezende, Diogo dos Santos da Mata; Santos‐Silva, Alan Roger; Jorge, Jacks; Silva, Wagner Gomes da; Pires, Fábio Ramôa; Rocha, André Caroli; Campos, Wladimir Gushiken de; Caldato, Milena Coelho Fernandes; Martin, Regina Matsunaga; Fonseca, Felipe Paiva; Pontes, Hélder Antônio Rebelo

doi:10.1016/j.oooo.2017.09.011

Cited by 27 publications

(16 citation statements)

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“…The lesion is more prevalent in patients older than 50 years and three times more frequent in women [ 6 ]. The female preponderance is speculated to be due to women's lower body mass that would lead to an earlier clinical manifestation of the disease [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Mandibular Osteitis Fibrosa Cystica as First Sign of Vitamin D Deficiency

Mellouli

Chebil

Darej

et al. 2018

Case Reports in Dentistry

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Introduction Brown tumors of hyperparathyroidism are locally destructive bone lesions. They are the late clinical consequence of the disease. They can occur in primary, secondary, and rarely tertiary forms. They affect usually long bones and less frequently those of the maxilla. Case Report Our 45-year-old female patient presented with a mandibular tumor next to the first right lower molar. At first, we have chosen tooth extraction and tumor excision. When the histological report showed the giant cell tumor we suspected a metabolic bone disorder. Biochemical tests screened hyperparathyroidism and severe vitamin D deficiency, and parathyroid scintiscan revealed parathyroid adenoma. Discussion The association of hyperparathyroidism and vitamin D deficiency leads to diagnostic uncertainty. First, secondary hyperparathyroidism can be due vitamin D deficiency. Second, data available show that vitamin D deficiency is more prevalent in patients with primary hyperparathyroidism than in general population. Hyperparathyroidism management is based on correct and precise diagnosis. Furthermore, the resolution of brown tumors depends on the cure of hyperparathyroidism. In fact, bone lesions should regress after biological tests' normalization. Conclusion Clinicians should be aware of such rare and complicated presentation. They must consider the diagnosis of the brown tumor to avoid extensive surgical excision and teeth extractions.

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Section: Discussionmentioning

confidence: 99%

“…When they arise in the maxillofacial region, the mandible is so far the most frequent localization [ 8 ]. However, both mandible and maxilla affected individually or simultaneously were reported [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Mandibular Osteitis Fibrosa Cystica as First Sign of Vitamin D Deficiency

Mellouli

Chebil

Darej

et al. 2018

Case Reports in Dentistry

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“…The overlapping of clinical, radiological, and histopathological features of fibrous dysplasia with other fibro‐osseous lesions and odontogenic tumors results in a comprehensive list of differential diagnoses. These include cemento‐ossifying fibroma, focal cemento‐osseous dysplasia, desmoplastic ameloblastoma, and osseous manifestations of hyperparathyroidism secondary to chronic kidney disease . Differentiation between them is crucial since these lesions require different clinical approaches in their management.…”

Section: Diagnosis: Combining Clinical Radiological Histopathologicmentioning

confidence: 99%

“…This condition usually presents diffuse involvement of maxilla and mandible. Patients also show altered serum levels of calcium, phosphate, and parathyroid hormone, and therefore, knowledge on the systemic health condition of patients is very important to differentiate both entities …”

Section: Diagnosis: Combining Clinical Radiological Histopathologicmentioning

confidence: 99%

Fibrous dysplasia of the jaws: Integrating molecular pathogenesis with clinical, radiological, and histopathological features

Pereira

Gomes

Brennan

et al. 2018

J Oral Pathology Medicine

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Fibrous dysplasia is a non‐neoplastic developmental process that affects the craniofacial bones, characterized by painless enlargement as a result of bone substitution by abnormal fibrous tissue. Postzygotic somatic activating mutations in the GNAS1 gene cause fibrous dysplasia and have been extensively investigated, as well as being helpful in the differential diagnosis of the disease. Fibrous dysplasia may involve one (monostotic) or multiple bones (polyostotic), sporadically or in association with McCune‐Albright syndrome, Jeffe‐Lichenstein syndrome, or Mazabreud syndrome. This review summarizes the current knowledge on fibrous dysplasia, emphasizing the value of integrating the understanding of its molecular pathogenesis with the clinical, radiological, and histopathological features. In addition, we address important aspects related to the differential diagnosis and patient management.

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“…As alterações radiográficas na OR dos maxilares incluem aparência óssea de vidro despolido, hipercementose e reabsorção óssea com a perda parcial ou total da lâmina dura. A OR também está associada a erupção tardia, espaçamento dentário, mobilidade dentária, má definição de pontos anatômicos e propensão a fratura mandibular (Pontes et al, 2018;Yepes, 2017).…”

Section: Alterações óSseasunclassified

Alterações bucais em crianças e adolescentes transplantados renais

Tuma¹

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Tuma MM. Oral Changes in renal transplanted children and adolescents [dissertation]. São Paulo: Faculdade de Odontologia da USP; 2018. Versão Original. Renal transplanted children and adolescents need dental care on a routine basis as there are oral changes related to some underlying diseases as well as to the transplantation itself and immunosuppressive therapy. The objective of the present study is to know and identify the oral health of these patients in order to seek possible relationships with the underlying disease which led to kidney transplantation, transplantation time and adopted immunosuppressive approach. Anamnesis and clinical examination were conducted to evaluate the presence of caries lesions (DMFT/dmf-t indexes), enamel defects (modified DDE index), periodontal condition (modified IPC index) and presence of soft tissue changes. This is an observational, cross-sectional study performed between August 2017 and June 2018 in which renal transplant recipients aged 2-17 years old were followed up at the São Paulo Hospital of Kidney in Brazil. A total of 120 participants were included, with 63 (52.5%) being males with mean age 12.78±3.9 years old. Unknown causes of renal failure involved the majority of the cases, that is, 28 (23.3%), whereas posterior urethral valve (PUV) involved 14 cases (11.7%). Gingival bleeding was observed in 115 (95.8%) participants, dental calculus in 69 (57.5%), caries experience in 51 (42.5%), enamel defects in 49 (40.8%), drug-related gingival hyperplasia (DRGH) in 20 (16.7%), xerostomia in 15 (12.5%) and soft tissue lesions in 5 (4.2%), such as ulcers, geographic tongue and oral wart lesions. The majority of the participants (55%) needed some dental treatment. The use of amlodipine and anticonvulsants has been associated with the presence of DRGH, whereas the immunosuppressant everolimus associated with ulceration (p < 0.05). We have concluded that periodontal disease and caries lesions were the most frequent oral conditions, leading to significant need for dental treatment in the population studied. Most of the oral changes observed were related to the underlying disease (i.e. renal failure), especially enamel defects. Oral opportunistic infections were rarely observed and drug treatment was associated with the presence of ulceration (use of everolimus) and DRGH (use of amlodipine and anticonvulsivants).

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Oral and maxillofacial manifestations of chronic kidney disease–mineral and bone disorder: a multicenter retrospective study

Cited by 27 publications

References 23 publications

Mandibular Osteitis Fibrosa Cystica as First Sign of Vitamin D Deficiency

Mandibular Osteitis Fibrosa Cystica as First Sign of Vitamin D Deficiency

Fibrous dysplasia of the jaws: Integrating molecular pathogenesis with clinical, radiological, and histopathological features

Alterações bucais em crianças e adolescentes transplantados renais

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