Dental patient with acromegaly: a case report

Kashyap, Roopashri Rajesh; Babu, Subhas; Shetty, Shishir Ram

doi:10.2334/josnusd.53.133

Cited by 23 publications

(25 citation statements)

References 7 publications

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“…It is generally believed that acromegalic patients are characterized by a Class 3 malocclusion associated with a severe mandibular prognathism, increased gonial angle and typical alteration of the facial features (5-8). In the present study, the ANB angle of acromegalic patients showed statisticaly significant difference from healthy individuals for both of the gender.…”

Section: Discussionmentioning

confidence: 99%

“…The somatic effects include stimulation of growth of many tissues, such as skin, epithelial tissues, connective tissues, cartilage, bone, viscera, cardiovascular and pulmonary system (4). Under the influence of the GH and IGF-I, new bone formation leads to characteristic alterations in the craniofacial morphology, such as the mandibular prognathism, diastemas, malocclusion, frontal bossing and hypertrophy of sinuses, especially the frontal sinuses (2,5-8). Acromegaly is a slowly progressive disease and these craniofacial morphologic changes occur gradually, for this reason the diagnosis may be difficult or delayed (9).…”

Section: Introductionmentioning

confidence: 99%

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The bite force and craniofacial morphology in patients with acromegaly: A pilot study

Karakış

Aktas-Yılmaz²,

Doğan³

et al. 2014

Med Oral

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Objectives: Acromegaly is a metabolic disorder caused by increased growth hormone secretion. As a consequence of acromegaly some typical craniofacial morphology changes appear. This pilot study was conducted to compare the bite force and the characteristic size and shape of the craniofacial components of acromegalic patients with the healthy Turkish individuals. In additon, the correlations between bite force and craniofacial morphology of patients with acromegaly and control individuals were evaluated. Study Design: The maximum bite force of the participants was recorded with strain-gage transducer. Lateral x-ray scans were made under standard conditions, in centric occlusion. On cephalograms, the linear and angular measurements was performed. Results: Patients with acromegaly showed increased anterior and posterior total face height, ramus length, width of frontal sinuse, gonial angle and a negative difference between maxillary and mandibular protrusions. In addition, females with acromegaly showed larger lower anterior face height and sella turcica, decreased facial angle, increased mandibular plane angle. The cephalometric measurements, except one did not showed correlation with the bite force in acromegalic patients. In control group, significant correlations were observed between anterior total face height and anterior lower face height, mandibular plane angle and gonial angle. Conclusions: The greater changes were observed in the mandible. The maximum bite force of patients with acromegaly showed no difference from healthy individuals. The non-significant difference of bite force between healthy participants and acromegalic patients provide important information for dental treatment and prosthetic rehabilitation of acromegalic patients. Key words:Acromegaly, bite force, cephalometric analysis, mandibular prognathism.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The bite force and craniofacial morphology in patients with acromegaly: A pilot study

Karakış

Aktas-Yılmaz²,

Doğan³

et al. 2014

Med Oral

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“…In view of the major impact of changes in the orofacial area and the dental occlusion, Herrmann et al concluded patients with acromegaly require good oral and maxillofacial examination in strict co-operation between endocrinologists, dentists and oral surgeons [6]. Kashyap et al suggest that acromegaly should be considered in patients who develop malocclusion after adolescence [7]. …”

Section: Discussionmentioning

confidence: 99%

GH-secreting pituitary macroadenoma (acromegaly) associated with progressive dental malocclusion and refractory CPAP treatment

et al. 2017

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BackgroundA link between progressive dental malocclusion, the use of a continuous positive airway pressure mask and GH-secreting pituitary macroadenoma (acromegaly) has not been previously reported. The present clinicopathological analysis stresses that tooth malposition should not be seen exclusively as a local process.Case presentationA 62-year-old caucasian man with no relevant medical history reported difficulty chewing food and perceived voice alteration during his annual periodontal check-up. He also referred stiffness of the tongue, face, and submandibular area. The patient had been diagnosed with obstructive sleep apnea syndrome two years previously, since when he had worn a continuous positive airway pressure device during sleep. Exploration of the occlusion revealed significant changes: an atypical left lateral and anterior open bite with major buccoversion of teeth 33, 34, 35, 36. Inspection of the soft tissue revealed only macroglossia, although external palpation indicated a subcutaneous stiffness of the submandibular area. General analytical tests, including hormone profiles, and magnetic resonance imaging confirmed the diagnosis of acromegaly induced by a pituitary adenoma. Intrasellar tumor resection via transsphenoidal approach was performed. After surgery, the patient already noted a marked improvement of all symptoms associated with the acromegaly. Desaturation data also evolved favourably and the pulmonologist advised the patient to abandon the continuous positive airway pressure treatment.ConclusionProgressive dental malocclusion may be associated with a systemic disease and the use of a nasal mask with premaxillary support may distort the diagnosis of acromegaly.

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“…Acromegaly is an endocrine disorder characterized by an acquired, progressive somatic disfigurement, mainly involving the face and extremities due to the excessive production of growth hormone . This multisystem disorder results from chronic exposure to abnormally increased levels of growth hormone and insulin‐like growth factor‐1 (IGF‐1), and is associated with significant morbidity and mortality . The characteristic signs and symptoms of acromegaly arise from the adverse effects of excessive growth hormone produced by a pituitary adenoma or from other concomitant endocrinological involvement after the closure of epiphyseal plates .…”

mentioning

confidence: 99%

“…This multisystem disorder results from chronic exposure to abnormally increased levels of growth hormone and insulin‐like growth factor‐1 (IGF‐1), and is associated with significant morbidity and mortality . The characteristic signs and symptoms of acromegaly arise from the adverse effects of excessive growth hormone produced by a pituitary adenoma or from other concomitant endocrinological involvement after the closure of epiphyseal plates . A recent epidemiological study stated that the total prevalence ranged between 2.8 and 13.7 cases per 100,000 people, and the incidence ranged between 0.2 and 1.1 cases per 100,000 people .…”

mentioning

confidence: 99%

Dental Implant Therapy in a Patient with Acromegaly: A Clinical Report

Kernen

2019

Journal of Prosthodontics

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Acromegaly is an adult endocrine disorder that results from excessive growth hormone after closure of the growth plates and is associated with significant morbidity and increased mortality. The orofacial features of patients with acromegaly are thick lips with a tendency towards mandibular overgrowth with prognathism, jaw thickening, maxillary widening, drifting of teeth, malocclusion, and increased gonial angle, all of which can challenge the prosthodontist in dental rehabilitation. Additionally, excessive secretion of growth hormone and insulin‐like growth factors have been shown to increase bone turnover, which in turn leads to weakening of bone microarchitecture and high risk of fragility fractures. This clinical report describes the 4‐year follow‐up of a 59‐year‐old white male with acromegaly, who was managed successfully by using dental implants for replacing his missing teeth. Considerations related to treatment planning, implant surgery, bone remodeling, and management of dental occlusion are discussed. This is the first clinical report in the dental literature describing the use of dental implants in an acromegaly patient.

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Dental patient with acromegaly: a case report

Cited by 23 publications

References 7 publications

The bite force and craniofacial morphology in patients with acromegaly: A pilot study

The bite force and craniofacial morphology in patients with acromegaly: A pilot study

GH-secreting pituitary macroadenoma (acromegaly) associated with progressive dental malocclusion and refractory CPAP treatment

Dental Implant Therapy in a Patient with Acromegaly: A Clinical Report

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