Gingival Enlargement in Acromegaly

Capoglu, Ilyas; Yılmaz, Ali Osman; Ünüvar, Necdet; Orbak, Recep; Aksoy, Hülya; Yesilyurt, Hakki

doi:10.1385/endo:18:3:207

Cited by 13 publications

(7 citation statements)

References 22 publications

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“…Although GH excess has complex consequences on bone and connective tissue metabolism there is yet very few data about periodontal pathologies in these patients (25)(26)(27). As long as our English literature search is concerned, we could fi nd only one study evaluating the periodontal status in acromegalics.…”

Section: Tab 4 Chronic Periodontitis Cases In Acromegalicsmentioning

confidence: 99%

Acromegaly is protective for periodontal tissue – advanced chronic periodontitis is rare in acromegalics

Başçil¹,

Serinsöz²,

Tütüncü³

2014

BLL

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Abstract:Background: Acromegaly is a complex syndrome which infl uences the connective tissue and bone metabolism. Although the effects of excess growth hormone on bone tissue are well known, its effect on periodontal tissue is an enigma. Methods: A total of 23 acromegalic patients (mean age 48.13 ± 9.4 years) were included randomly in to this cross-sectional study. The control group consisted of 60 healthy (mean age 50.3 ± 8.5) individuals. All participants were examined by the same periodontist to evaluate periodontal disease status. Results: We studied a group of 23 acromegalic patients (11 females, 12 males) with estimated duration of disease from minimum of one year to 10 years (mean 4.52 ± 2.9 years). The frequency of advanced chronic periodontitis in acromegalics was signifi cantly lower than in the healthy group (p = 0.002). Advanced periodontitis was 10 times more frequent in healthy population than in the acromegalics. Conclusions: Advanced chronic periodontitis is 10 times less frequent in acromegalics than in healthy population. Acromegaly is a disease which seems to be protective for periodontal tissue (Tab. 4, Ref. 30). Text in PDF www.elis.sk.

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Section: Tab 4 Chronic Periodontitis Cases In Acromegalicsmentioning

confidence: 99%

Acromegaly is protective for periodontal tissue – advanced chronic periodontitis is rare in acromegalics

Başçil¹,

Serinsöz²,

Tütüncü³

2014

BLL

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“…There is a clinical report of gingival hypertrophy in 8 of 11 acromegaly patients whose blood GH levels were controlled. 1 It was also reported that local injection of small doses of The Endocrinologist • Volume 17, Number 1, February 2007 Gingivitis in Acromegaly somatotrophic hormone into the oral mucosa of young adult rats causes enlargement of epithelial cells. 5 The gingivitis was not improved until a GH secretion inhibitor was administered; this suggests that the acromegaly induced enlargement of the gingiva.…”

Section: Discussionmentioning

confidence: 99%

Gingivitis in Acromegaly Successfully Treated With a Growth Hormone Secretion Inhibitor

Mine¹,

Satoh²,

Nakagawa³

et al. 2007

The Endocrinologist

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Aim: Acromegaly is caused by excessive secretion of growth hormone (GH) usually associated with a pituitary adenoma. Acromegaly is associated with several oral complications. There are few reports of gingivitis in patients with acromegaly. This paper describes a case of intractable gingivitis in acromegaly. Materials and Methods:A 48-year-old Japanese woman was referred to our department in June 1998 complaining of gingival bleeding. The clinical diagnosis of marginal periodontitis was made. Extraction of loose teeth and scaling were performed and the patient was given brushing instructions. The gingiva of same region, however, swelled repeatedly. The patient visited the department of internal medicine for treatment of hypertension. The blood level of GH was high and a pituitary adenoma was discovered. The patient was diagnosed with a GH-producing pituitary adenoma-associated acromegaly. Administration of bromocriptine mesilate (Parlodel), a GH secretion inhibitor, was initiated. Results and Conclusions: Gingival swelling rapidly diminished and the gingival pocket was reduced. It is suggested that abnormal GH secretion should be included as a cause of intractable gingivitis.

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“…Indeed, we found no case of diffuse gingival hypertrophy (only one case of bilateral palatal tuberous outgrowth). One study described mild to moderate gingival ‘enlargement’ in 8 acromegalic patients out of 11 examined ( 8 ) but it was not reported if this term means thick gingival biotype or gingival hypertrophy and if periodontitis was associated. In the same way, although there is preclinical evidence of a trophic role of acromegaly on cementum ( 25 ) and two published cases reports mentioning radiological hypercementosis on molars of acromegalic patients ( 12 , 13 ), systematic orthopantomogram revealed only two cases of hypercementosis, each affecting only one tooth per patient.…”

Section: Discussionmentioning

confidence: 99%

“…A total score below 80 points, that is, 66% is considered as a clinically significant impact of acromegaly on patients' quality of life. This score can be divided into three dimensions: Physical Symptoms subscale (i.e., Items 1,3,9,[13][14][15]19, and 22), Appearance Issues subscale (i.e., Items 2,4,7,11,12,16,and 17), and Personal Relation Issues subscale ( Items 5,6,8,10,18,20 and 21). As for the global score, results for each dimension were scored on a 0 to 100 basis.…”

Section: Study Populationmentioning

confidence: 99%

“…Indeed, the consequences of elevated GH and IGF-1 on gingivae is debated. Some observations describe a gingival enlargement in acromegalic patients (8), which is known to promote periodontal disease leading to tooth loss, while others suggest that acromegaly could protect against this frequent medical condition (9,10,11). Besides, two cases reports described hypercementosis (overgrowth of the cement) in an acromegalic patient (12,13) but the link with the disease remains questionable.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of oro-dental manifestations in a series of acromegalic patients, the AcroDent study

Roumeau

Thevenon

Ouchchane

et al. 2020

Endocrine Connections

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Objective: The dental and periodondal impact of GH/IGF-1 hypersecretion has been poorly investigated until now. Our aim is to precisely describe the oro-dental state of acromegalic patients and to study the impact of GH/IGF-1 hypersecretion on patients' reported oral health related quality of life (OHRQoL). Methods: After collecting characteristics of their disease, acromegalic patients answered the GOHAI questionnaire assessing their OHRQoL, the AcroQoL questionnaire and then benefited from a complete stomatological and radiological examination (orthopantomogram systematically, retro-alveolar radiography or Cone Beam computed tomography if necessary). Results: 29 patients aged 59.1±16.0 years were included. The average DMFT index (sum of Decayed, Missing and Filled Teeth per patient) was 19.0±7.8. 16/29 patients had a gingivitis and 18/29 a mild to moderate chronic periodontitis, but no case of severe chronic periodontitis was found, probably because the frequency of a protective thick gingival biotype was increased (9/29). No case of generalized gingival hypertrophy or diffuse hyper-cementosis was observed. According to the Add-GOHAI score, only 8/26 patients had a satisfactory OHRQoL. This parameter was correlated to the acromegaly-specific quality of life according to the AcroQoL score. Interestingly, 11/29 patients had bulky oral bony outgrowths (OBO) such as large maxillary or mandibular tori and multiple vestibular exostosis. Conclusions: The unsatisfactory OHRQoL reported by acromegalic patients contrasts with a rather good objective oro-dental state and annual oral examination seems relevant in this population. Finally, we report that huge OBO could be helpful signposts for the diagnosis of acromegaly.

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Gingival Enlargement in Acromegaly

Cited by 13 publications

References 22 publications

Acromegaly is protective for periodontal tissue – advanced chronic periodontitis is rare in acromegalics

Acromegaly is protective for periodontal tissue – advanced chronic periodontitis is rare in acromegalics

Gingivitis in Acromegaly Successfully Treated With a Growth Hormone Secretion Inhibitor

Assessment of oro-dental manifestations in a series of acromegalic patients, the AcroDent study

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