Objective: The aim of this study was to compare osteoporotic changes of jaw bones between normal population and patients with primary hyperparathyroidism (pHPT) by using panoramic radiomorphometric analyses. Material and Methods: Panoramic radiographs of 48 healthy individuals and 48 patients with pHPT were evaluated. The values of the panoramic mandibular index (PMI), mental index (MI) mandibular cortical width (MCW), amount of alveolar bone resorption (AABR) were measured. Mandibular cortical index (MCI) was recorded on panoramic radiographs according to C1, C2 and C3 classes with increased trabecular structure of the cortical bone. In panoramic radiographs, carotid artery calcification was examined. Results: There was no statistically significant difference between the patient group and the control group for PMI, MI, MCW and AABR values from radiomorphometric measurements. While there was a significant difference between categories C1 and C3 of MCI values between patient and control group; there was no significant difference for category C2 values. Unilateral carotid artery calcification was observed on panoramic radiography of 5 individuals in the patient group. Conclusion: Osteoporotic changes were not observed in patients with pHPT as compared with control group by using radiomorphometric analysis, while mandibular cortical destruction was observed in pHPT patient group.
Keywords: Primary hyperparathyroidism; cortical bone; radiomorphometry; panoramic radiography
Amaç: Bu çalışma, primer hiperparatiroidili (pHPT) hastalardaki çene kemiğine ait osteoporotik değişikliklerin, panoramik radyografi kullanılarak belirlenen radyomorfometrik indeksler ile değerlendirilmesini amaçlamıştır. Gereç ve Yöntemler: pHPT tanısı alan 48 birey ile kontrol grubunu oluşturan sağlıklı 48 bireyin panoramik radyografileri üzerinde; panoramik mandibular indeks (PMI), mental indeks (MI), mandibular kortikal kalınlık (MKK), alveoler kemik rezorpsiyon miktarı (AKRM) ölçüldü. Mandibular kortikal indeks (MKI) panoramik radyografiler üzerinde, kortikal kemiğin artmış trabeküler yapısının C1, C2 ve C3 sınıflarından uyumlu görünüm sergilediği sınıfa göre kaydedildi. Panoramik radyografide, karotid arter kalsifikasyonu varlığı araştırıldı. Bulgular: Radyomorfometrik ölçümlerden PMI, MI, MKK ve AKRM değerleri için hasta grubu ile kontrol grubu arasında istatistiksel olarak anlamlı fark bulunmadı. Hasta grubu ile kontrol grubu arasında MKI sınıflandırmalarından C1 ve C3 sınıf değerleri arasında anlamlı bir fark var iken; C2 sınıf değerleri arasında anlamlı bir fark bulunmamıştır. Hasta grubundaki, 5 bireyin panoramik radyografisinde unilateral karotid arter kalsifikasyonu izlendi. Sonuç: Radyomorfometrik analizler ile pHPT hastalarında kontrol grubuna kıyasla anlamlı osteoporotik değişiklikler izlenmemiş olmakla birlikte pHPT'li hastalarda, mandibular kortikal destrüksiyon tespit edilmiştir.
Anahtar Kelimeler: Primer hiperparatiroidi; kortikal kemik; radyomorfometri; panoramik radyografi
- Rolighed L, Rejnmark L, Christiansen P. Bone Involvement in Primary Hyperparathyroidism and Changes After Parathyroidectomy. Eur Endocrinol. 2014;10(1):84-7. [Crossref] [PubMed] [PMC]
- Padbury AD Jr, Tözüm TF, Taba M Jr, Ealba EL, West BT, Burney RE, et al. The impact of primary hyperparathyroidism on the oral cavity. J Clin Endocrinol Metab. 2006;91(9):3439-45. [Crossref] [PubMed]
- Klemetti E, Kolmakov S, Heiskanen P, Vainio P, Lassila V. Panoramic mandibular index and bone mineral densities in postmenopausal women. Oral Surg Oral Med Oral Pathol. 1993;75(6):774-9. [Crossref] [PubMed]
- Palla B, Burian E, Fliefel R, Otto S. Systematic review of oral manifestations related to hyperparathyroidism. Clin Oral Investig. 2018;22(1):1-27. [Crossref] [PubMed]
- Hekmatian E, Sharif S, Khodaian N. Literature review digital subtraction radiography in dentistry. Dent Res J. 2008;2:1-8. [Link]
- Lopes R, Betrouni N. Fractal and multifractal analysis: a review. Med Image Anal. 2009;13(4):634-49. [Crossref] [PubMed]
- Rosenberg E. Hyperparathyroidism. A review of 220 proved cases with special emphasis on findings in the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1962;15:84-94. [Link]
- Gümüşsoy İ, Duman ŞB, Miloğlu Ö. Hiperparatiroidili hastalarda panoramik indeksler ve fraktal analiz kullanılarak mandibular kemiğin incelenmesi [Evaluation of mandibular bone using panoramic-based and fractal analysis in patients with hyperparathyroidism. Selcuk Dent J. 2019;6:299-303. [Link]
- Henriques JC, Castilho JC, Jacobs R, Amorim JB, Rosa RR, Matai CV. Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism. Clin Oral Investig. 2013;17(6):1611-7. [Crossref] [PubMed]
- Rai S, Bhadada SK, Rattan V, Bhansali A, Rao DS, Shah V. Oro-mandibular manifestations of primary hyperparathyroidism. Indian J Dent Res. 2012;23(3):384-7. [Crossref] [PubMed]
- Benson BW, Prihoda TJ, Glass BJ. Variations in adult cortical bone mass as measured by a panoramic mandibular index. Oral Surg Oral Med Oral Pathol. 1991;71(3):349-56. [Crossref] [PubMed]
- Kribbs PJ. Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent. 1990;63(2):218-22. [Crossref] [PubMed]
- Ledgerton D, Horner K, Devlin H, Worthington H. Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol. 1999;28(3):173-81. [Crossref] [PubMed]
- Kelly WH, Mirahmadi MK, Simon JH, Gorman JT. Radiographic changes of the jawbones in end stage renal disease. Oral Surg Oral Med Oral Pathol. 1980;50(4):372-81. [Crossref] [PubMed]
- Yeluri G, Kumar CA, Raghav N. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography. Contemp Clin Dent. 2015;6(Suppl 1):S147-51. [Crossref] [PubMed] [PMC]
- Dutra V, Yang J, Devlin H, Susin C. Radiomorphometric indices and their relation to gender, age, and dental status. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(4):479-84. [Crossref] [PubMed]
- Yüzügüllü B, Gulsahi A, Imirzalioglu P. Radiomorphometric indices and their relation to alveolar bone loss in completely edentulous Turkish patients: a retrospective study. J Prosthet Dent. 2009;101(3):160-5. [Crossref] [PubMed]
- Halling A, Persson GR, Berglund J, Johansson O, Renvert S. Comparison between the Klemetti index and heel DXA BMD measurements in the diagnosis of reduced skeletal bone mineral density in the elderly. Osteoporos Int. 2005;16(8):999-1003. [Crossref] [PubMed]
- Hayes CW, Conway WF. Hyperparathyroidism. Radiol Clin North Am. 1991;29(1):85-96. [PubMed]
- Bollen AM, Taguchi A, Hujoel PP, Hollender LG. Case-control study on self-reported osteoporotic fractures and mandibular cortical bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(4):518-24. [Crossref] [PubMed]
- Drozdzowska B, Pluskiewicz W, Tarnawska B. Panoramic-based mandibular indices in relation to mandibular bone mineral density and skeletal status assessed by dual energy X-ray absorptiometry and quantitative ultrasound. Dentomaxillofac Radiol. 2002;31(6):361-7. [Crossref] [PubMed]
- Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tanimoto K, et al. Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners' diagnostic performance. Osteoporos Int. 2003;14(8):659-64. [Crossref] [PubMed]
- Çağirankaya LB, Uysal S, Hatipoğlu MG. Oral radyologların mandibular kortikal indeks değerlendirmeleri arasındaki uyum [Agreement among oral radiologists in assesment of mandibular cortical index]. Gazi Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2010;27(3):153-6. [Link]
- Ofluoğlu D, Ergun S. Osteoporoz hastalarinda oral cerrahi uygulamalar [Oral surgical procedures in patients with osteoporosis]. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2015;5:140-8. [Crossref]
- Wical KE, Swoope CC. Studies of residual ridge resorption. I. Use of panoramic radiographs for evaluation and classification of mandibular resorption. J Prosthet Dent. 1974;32(1):7-12. [Crossref] [PubMed]
- Hirai T, Ishijima T, Hashikawa Y, Yajima T. Osteoporosis and reduction of residual ridge in edentulous patients. J Prosthet Dent. 1993;69(1):49-56. [Crossref] [PubMed]
- Packota GV, Hoover JN, Neufeld BD. A study of the height of intact alveolar bone on panoramic radiographs of adult patients. J Prosthet Dent. 1988;60(4):504-9. [Crossref] [PubMed]
- Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J Prosthet Dent. 1972;27(2):120-32. [Crossref] [PubMed]
- Maxwell DR, Spolnik KJ, Cockerill EM, Patterson SS, Kleit SA. Roentgenographic manifestations of maxillomandibular renal osteodystrophy. Nephron. 1985;41(3):223-9. [Crossref] [PubMed]
- Altun O, Bilge OM. Diagnostic reliability of the rate of alveolar crest resorption, antegonial index and mental index from digital panoramic radiomorphometric analysis in osteoporosis diagnosis and their comparison to the dexa. Int J Med Res Pharm Sci. 2019;6:22-9. [Link]
- Cakur B, Sahin A, Dagistan S, Altun O, Caglayan F, Miloglu O, et al. Dental panoramic radiography in the diagnosis of osteoporosis. J Int Med Res. 2008;36(4):792-9. [Crossref] [PubMed]
- Dagistan S, Miloglu O, Caglayan F. Changes in jawbones of male patients with chronic renal failure on digital panoramic radiographs. Eur J Dent. 2016;10(1):64-8. [Crossref] [PubMed] [PMC]
- Leite AF, Figueiredo PT, Guia CM, Melo NS, de Paula AP. Correlations between seven panoramic radiomorphometric indices and bone mineral density in postmenopausal women. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(3):449-56. [Crossref] [PubMed]
- Martínez-Maestre MÁ, Corcuera Flores JR, Machuca G, González-Cejudo C, Torrejón R, Castelo-Branco C. Panoramic radiomorphometry and vertebral fractures in Spanish postmenopausal women. Maturitas. 2013;76(4):364-9. [Crossref] [PubMed]
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