Systematic review of oral manifestations related to hyperparathyroidism

Abstract

What was thought to be a characteristic finding of HPT, mandibular radiolucency occurred in only a minor portion of cases. Furthermore, the pathognomonic sign of HPT on radiograph, loss of lamina dura, was only the third most common presentation. Bone pathology was most commonly reported in literature, but should not be assumed the only oral sequelae of hyperparathyroidism.

Increased risk for tooth extraction in primary hyperparathyroidism and hypercalcemia: a population study

“…Pronounced periodontal lesions are predominantly observed in advanced stages of pHPT. Our findings of a correlation between severity of hypercalcemia and an increased risk of tooth loss by extraction are consistent with previous knowledge [9]. Furthermore, the analyses indicated an amplified increased risk for tooth loss associated with female gender and increasing age in the pHPT cohort compared to the reference population, independent of calcium-levels.…”

“…The findings were most commonly related to expansile bone effects and the second most common finding was oral pain. Frequent radiological findings were cortical destruction and tooth displacement [9]. Loss of the lamina dura, previously considered pathognomonic for pHPT, seemed to be one of the most common findings and was suggested to be related to increased bone turnover.…”

Secondary hyperparathyroidism causing increased jaw bone density and mandibular pain: a case report

“…9 The systemic symptoms of hyperparathyroidism are described as "stones, bones, groans, with psychiatric overtones." 6 In our patient, the primary complaint was prolonged jaw pain without evidence of chronic kidney disease. In a recent systematic review, the incidence of oral pain in patients with hyperparathyroidism was 14.0%.…”

“…Hyperparathyroidism predominates in women, with a general male:female ratio of 1:1.7. The average age of patients with hyperparathyroidism is 34.02 years, 6 but patients with secondary hyperparathyroidism may be slightly younger.…”

“…However, the most common reported symptom of hyperparathyroidism is facial asymmetry or swelling (78.0%), followed by oral pain and systemic symptoms (11.7%). 6 Bone expansion can be present with and without brown tumors. 10 Other oral manifestations include neuropathy, postextraction complications, periodontitis, and tooth mobility.…”