Advances in Oral and Maxillofacial Surgery (Oct 2021)

Clinical and scanographic mandibular abnormalities in patients with secondary hyperparathyroidism on maintenance hemodialysis

  • Cheboh Cho-Fon,
  • Nzana Victorine Bandolo,
  • Pierre Ongolo Zogo,
  • Mahamat Maimouna,
  • Ashuntantang Gloria Enow

Journal volume & issue
Vol. 4
p. 100189

Abstract

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Background: Mineral bone diseases in dialysis patients is a common but disturbing phenomenon. The involvement of the mandibular bone has been noted but few studies have investigated this in the sub Saharan region. Objectif: To describe the clinical and scanographic mandibular abnormalities in patients with secondary hyperparathyroidism on maintenance haemodialysis. Method: We conducted a cross sectional study where we included patients who had been on maintenance haemodialysis for at least 4 months with biochemical evidence of secondary hyperparathyroidism. We collected relevant medical and oral history. Thereafter, we evaluated oral functional status and performed CT scans of the mandible. Mandibular abnormalities, mental and gonial indices were noted. Data analysis was done with IBM SPSS 26.0 software. Statistical significance was set at a p value < 0.05. Results: A total of 38 patients were enrolled with a mean ± SD age of 44 ± 12.9 years. The median PTH level and dialysis vintage were 807.6[605.0, 1166.0]pg/ml and 51.0 [51.3–92.8]months respectively. Twenty-nine (76.3%) participants had oral functional abnormalities with xerostomia (96.6%) and pain during mastication (62.1%) being the most frequent. Mental index was reduced in 96.7% of participants. Scanographic mandibular abnormalities were present in 94.7% of the participants with osteoporosis (100%) and alterations of the bone trabeculae (22.2%), the most prevalent. There was a negative correlation between the left (r = −0.405, p = 0.012) and right (r = −0.358, p = 0.027) gonion indices, the left (r = −0.358, p = 0.027), and right (r = −0.397, p = 0.014) mental indices and the PTH Level. PTH levels were significantly higher in mandibular cortical index Class C patients (p = 0.001). Conclusion: Mandibular involvement in mineral bone disease and oral function abnormalities were frequent.

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