Gnathic Bones and Hyperparathyroidism: A Review on the Metabolic Bony Changes Affecting the Mandible and Maxilla in case of Hyperparathyroidism

Abstract

<jats:p>Parathyroid glands secrete the parathyroid hormone that plays an essential role in bone remodeling. Excessive production of parathyroid hormone causes a common metabolic bone disorder known as hyperparathyroidism that is classified into primary, secondary, or tertiary. In hyperparathyroidism, the late bony complication is manifested as a giant cell osteolytic lesion called “brown tumor.” Primary hyperparathyroidism is usually a sporadic disorder, but in minority of cases it occurs in inherited forms, and one of these forms is the hyperparathyroidism-jaw tumor syndrome, which is characterized by primary hyperparathyroidism and ossifying fibroma in the mandible and/or maxilla.</jats:p>

Peripheral giant cells granuloma as a rare early manifestation of primary hyperparathyroidism

“…3 Clinical symptoms caused by brown tumors depend on their location and size; they range from small asymptomatic lesion, discovered accidentally by radiological examination, to a large locally destructive lesion resulting in a variety of symptoms that are mostly related to facial deformation and disfiguration, such as difficulty in chewing, talking, and breathing. 1 This coincided with our patient who lost weight due to facial deformation that led to difficulty in chewing.…”

“…Hyperparathyroidism could be described as an endocrine disorder resulting from increased secretion of parathyroid hormone and is characterized by hypercalcemia due to increased mobilization of calcium from bone to circulation. 1 Primary hyperparathyroidism occurs due to parathyroid adenoma, which as initial presentation in most cases includes recurrent nephrolithiasis (10-25%), neuropsychiatric disorders, and peptic ulcer. GDD also called osteoclastomas or brown tumors when they are within the endocrinological sphere, are one of the least frequent, most controversial and least predictable tumors in their behavior.…”

Ossifying Fibroma of the Maxilla: A Case Report and Literature Update

“…Furthermore, recurrence is often unpredictable and frequently seen in younger patients. Therefore, a follow-up period of at least 10 years with an OPG once every three years is recommended by some authors [2]. Although enucleation and curettage may carry the highest risk for recurrence, such an approach is advocated by some authors as they are associated with less morbidity and uneventful healing in comparison to radical resection -which often requires bone grafting and could result in an aesthetic deformity and/or loss of function [19].…”

“…Ossifying fibroma is a rare benign fibro-osseous neoplasm of the jaw characterized by the replacement of normal bone tissue by a combination of fibrous tissue and newly formed calcified tissues of bone and/or cementum-like material [1]. Lesions predominately affect craniofacial bones unilaterally, with the mandible reportedly more commonly affected than the maxilla, where OF tends to affect the canine fossa and zygomatic arch regions [2,3]. Although commonly occur in the 2 nd to 4 th decades, OF can occasionally affect children and adolescents [4].…”

A patient with multiple brown tumors due to secondary hyperparathyroidism: A case report

“…It is a manifestation of hyperparathyroidism (HPT), resulting by the increased level of parathyroid hormone (PTH). [2] There are three HPT forms: primary, secondary and tertiary. The first one is usually caused by an adenoma or, rarely, by a carcinoma of parathyroid glands.…”