Roentgenographic Manifestations of Maxillomandibular Renal Osteodystrophy

Abstract

We examined 30 male chronic hemodialysis patients and 18 male controls without known bone or renal disease to determine the utility of maxillomandibular, non-dominant hand, shoulder and pelvis films in the evaluation of renal osteodystrophy. We used panoramic periapical radiographs to examine the maxilla and mandible and sensitive rapid processing films for the hand, shoulder and pelvis. Films were evaluated by experienced personnel without knowledge of the patients. There were significant differences between patients and controls in creatinine, urea nitrogen, total protein, albumin, alkaline phosphatase and phosphorus. Twenty-three patients had abnormal hand radiographs and 22 patients had abnormal jaw radiographs (p < 0.05 vs. controls). Four patients had changes in the hands, but not in the jaw; 4 had opposite findings. Changes in the jaw tended to be more severe than in the hands in those with involvement of both. We concluded that dental and hand radiography are good screening techniques for evaluating bone disease. They may be useful in evaluating treatment for renal osteodystrophy.

The effect of secondary hyperparathyroidism and hemodialysis therapy on alveolar bone and periodontium

“…(1968) who described the absence of lamina dura around all teeth and loss of cortical bone in patients with secondary HPT. Similarly Maxwell et al . (1985), in a comparative radiographical study of chronic hemodialysis patients, found an absence of lamina dura and bone resorption.…”

“…Our findings are somewhat different from Houston et al (1968) who described the absence of lamina dura around all teeth and loss of cortical bone in patients with secondary HPT. Similarly Maxwell et al (1985), in a comparative radiographical study of chronic hemodialysis patients, found an absence of lamina dura and bone resorption. Furthermore, Bras et al (1985) suggested that even marginal HPT could lead to extreme reduction in the bone height of the mandible.…”

Benign Fibro-Osseous Lesions of the Craniofacial Complex A Review

“…Craniofacial bone lesions may be seen in both primary and secondary hyperparathyroidism (HPT) with benign fibroosseous lesions being more often reported among patients with renal osteodystrophy [145][146][147][148][149][150][151][152]. The ''brown tumor'' of hyperparathyroidism, a giant cell lesion, may be encountered anywhere in the skeleton in both primary and secondary HPT.…”

Facial Leontiasis Ossea: A Rare Presentation of Hyperparathyroidism Secondary to Chronic Renal Insufficiency

“…Maxwell et al [18] reported radiologic abnormalities of the mandible in 73% of the patients studied, and when the hands were already involved the mandibular altera tions tended to be more severe. In all cases there had been parathyroid hyperfunction for years.…”