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Ruddocks LA, Nascimento AF, Bhattacharyya I, Islam MN, Cohen DM. Central odontogenic fibroma in association with brown tumor of hyperparathyroidism in a patient with neurofibromatosis type 1. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:e26-e32. [PMID: 34511348 DOI: 10.1016/j.oooo.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/04/2021] [Indexed: 11/24/2022]
Abstract
We present a patient with bone abnormalities and a myriad of lesions secondary to his redeveloping renal failure and neurofibromatosis type 1 (NF1). A 21-year-old male renal transplant recipient with NF1 presented with painless masses and large, irregular radiolucent lesions in the maxilla and mandible. After histologic examination, the lesion was diagnosed as a central odontogenic fibroma (COdF) in association with a central giant cell lesion, most consistent with brown tumor of hyperparathyroidism. The bone changes were interpreted to be highly suggestive of renal osteodystrophy. Around 30 cases of hybrid central giant cell granuloma-like lesion in association with central odontogenic fibroma have been reported. This, to our knowledge, is the first reported case of brown tumor in association with COdF. Our case provides further evidence of the giant cell component as the initiating entity in these hybrid lesions.
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Affiliation(s)
- Lauren A Ruddocks
- Resident, Oral & Maxillofacial Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
| | - Alessandra F Nascimento
- Unit Director, Bone & Soft Tissue Pathology, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Indraneel Bhattacharyya
- Division Director, Oral & Maxillofacial Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Mohammed N Islam
- Program Director, Oral & Maxillofacial Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Donald M Cohen
- Department Chair, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
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2
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Systematic review of oral manifestations related to hyperparathyroidism. Clin Oral Investig 2017; 22:1-27. [DOI: 10.1007/s00784-017-2124-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 05/10/2017] [Indexed: 12/29/2022]
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4
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Xi W, Bo H, Haiyang P, Chang L, Jinlin S, Ming T. [Oral health status of patients undergoing hemodialysis: a Meta-analysis]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:155-161. [PMID: 28682545 DOI: 10.7518/hxkq.2017.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to systematically evaluate the oral health status of patients suffering from chronic renal failure and undergoing hemodialysis (HD). METHODS Electronic databases, namely, China National Knowledge Infrastructure, Wanfang Data base, PubMed, Web of Science, and Cochrane Library, were searched until May 2016 for cross-sectional and case-control studies that investigated the oral health status of patients suffering from chronic renal failure and undergoing HD. Two reviewers independently screened the trials, extracted the data, assessed the quality, and conducted a Meta-analysis with RevMan 5.3 in accordance with the inclusion and exclusion criteria. RESULTS Sixteen studies satisfied the eligibility criteria. Meta-analysis revealed that plaque index (MD=0.62, 95%CI: 0.51-0.72), calculus index (MD=1.09, 95%CI: 0.56-1.63), probing depth (MD=0.63, 95%CI: 0.29-0.98), and attachment loss (MD=0.63, 95%CI: 0.56-0.69) were significantly higher in the patients undergoing HD than in the healthy control group (P<0.01). No significant differences in decayed missing filled teeth (MD=1.12, 95%CI: -1.08-3.32) were observed between the patients undergoing HD and the healthy control group (P=0.32). CONCLUSIONS The prevalence of caries in patients undergoing HD is similar to that in the healthy control group. However, these patients are at a higher risk of acquiring periodontal diseases than the healthy control group. Thus, the oral health status of these patients should be further evaluated in clinical treatments.
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Affiliation(s)
- Wei Xi
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hu Bo
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Peng Haiyang
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Liu Chang
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Song Jinlin
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Tang Ming
- Dept. of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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5
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Davis EM. Oral Manifestations of Chronic Kidney Disease and Renal Secondary Hyperparathyroidism: A Comparative Review. J Vet Dent 2015; 32:87-98. [PMID: 26415385 DOI: 10.1177/089875641503200202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Recent epidemiological studies have demonstrated that significant associations exist between oral disease and diseases involving non-oral tissues. Occasionally, the roles may be reversed and the oral cavity can be severely affected by systemic disease originating in another part of the body. Renal secondary hyperparathyroidism is a common endocrinopathy that occurs as a consequence of chronic azotemic kidney disease. Renal osteodystrophy, the most dramatic clinical consequence of renal secondary hyperparathyroidism is uncommon, but can result in demineralization of maxillofacial bones, loosening of teeth, and pathological jaw fractures. The purpose of this report is to update the current understanding of the pathophysiology of this endocrine disease and to compare the oral manifestations of renal secondary hyperparathyroidism in humans and companion animals. A 50-year review of the veterinary literature was undertaken to examine the clinical presentation of renal osteodystrophy in dogs, and to determine what clinical consequences of renal secondary hyperparathyroidism have been reported in domestic cats.
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Lopes MLDDS, Albuquerque AFM, Germano AR, Queiroz LMG, Miguel MCDC, da Silveira ÉJD. Severe maxillofacial renal osteodystrophy in two patients with chronic kidney disease. Oral Maxillofac Surg 2015; 19:321-327. [PMID: 25784153 DOI: 10.1007/s10006-015-0490-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 03/09/2015] [Indexed: 06/04/2023]
Abstract
Renal osteodystrophy (ROD) is the bone pathology that occurs as an uncommon complication related to the several alterations in mineral metabolism present in patients with chronic kidney disease (CKD). This paper describes two cases of severe ROD affecting the maxilla and mandible and causing facial disfigurement of a young and a middle-aged female patient with CKD. Both patients had a history of secondary hyperparathyroidism, previously treated by surgery. The pathogenesis of the disease, as well as its clinical, imaging, and histopathological features, and management of the patient are discussed.
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Affiliation(s)
- Maria Luiza Diniz de Sousa Lopes
- Postgraduate Program in Oral Pathology, Dentistry Department, Federal University of Rio Grande do Norte, Avenida Salgado Filho, 1787-Lagoa Nova, Natal, RN, CEP 59.056-000, Brazil,
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7
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Jalali P, Kim SG. Multiple periradicular radiolucencies mimicking endodontic lesions in renal osteodystrophy of the mandible: a case report. Int Endod J 2015. [DOI: 10.1111/iej.12512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P. Jalali
- Division of Endodontics; Columbia University College of Dental Medicine; New York NY USA
| | - S. G. Kim
- Division of Endodontics; Columbia University College of Dental Medicine; New York NY USA
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8
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Raubenheimer EJ, Noffke CE, Mohamed A. Expansive jaw lesions in chronic kidney disease: review of the literature and a report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:340-5. [PMID: 25547821 DOI: 10.1016/j.oooo.2014.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/29/2014] [Accepted: 11/03/2014] [Indexed: 11/17/2022]
Abstract
Chronic kidney disease is an increasing public health problem, with a worldwide prevalence estimated to be between 8% and 16%. The metabolic alterations induce bone and soft tissue changes, and the encompassing term chronic kidney disease-mineral and bone disorder syndrome (CKD-MBD) is used to describe them. The cardinal manifestations of the syndrome are bone catabolism and soft tissue calcifications, which ultimately compromise the cardiovascular and skeletal systems. In rare cases, tumorous enlargement of the craniofacial bones occurs. This article provides a brief review of the pathogenesis and imaging of craniofacial changes in CKD-MBD and reports on two cases of expansive jaw lesions. The term expansive renal osteitis fibrosa is recommended to describe these lesions.
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Affiliation(s)
- Erich J Raubenheimer
- Oral Pathology, School of Oral Health Sciences, University of Limpopo, South Africa.
| | - Claudia E Noffke
- Radiology, School of Oral Health Sciences, University of Limpopo, South Africa
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J P, Nisha V A, Gs A, Ca P, Mm V. Oral manifestations in a renal osteodystrophy patient - a case report with review of literature. J Clin Diagn Res 2014; 8:ZD28-30. [PMID: 25302278 DOI: 10.7860/jcdr/2014/8879.4722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/13/2014] [Indexed: 11/24/2022]
Abstract
Renal Osteodystrophy (ROD) is a common complication of chronic renal disease (CRD) and is the part of a broad spectrum of disorders of mineral metabolism that occurs in the clinical setting. It occurs early in the course of chronic renal failure and progresses as the kidney function deteriorates. It is an osseous alteration believed to arise from increased parathyroid function associated with inappropriate calcium, phosphorus and vitamin D metabolism. Involvement of the jaws is common and radiographic alterations are often one of the earliest signs of chronic renal failure. Herein, reporting a case of Chronic Renal Failure (Bilateral Grade I Neuropathy) with ROD presenting oral manifestations in an 11-year -old male child.
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Affiliation(s)
- Parthiban J
- Reader, Department of Oral and Maxillofacial Surgery, Tagore Dental College and Hospital , Chennai, Tamil Nadu, India
| | - Aarthi Nisha V
- Senior Lecturer, Department of Oral Medicine & Radiology, Sree Balaji Dental College & Hospital, Bharath University , Chennai, Tamil Nadu, India
| | - Asokan Gs
- Reader, Department of Oral Medicine and Radiology, Tagore Dental College and Hospital , Chennai, Tamil Nadu, India
| | - Prakash Ca
- Reader, Department of Oral Surgery, CSI Dental College & Hospital , Madurai. Tamil Nadu, India
| | - Varadharaja Mm
- Senior Lecturer, Department of Orthodontics, Tagore Dental College and Hospital , Chennai, Tamil Nadu, India
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10
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Systemic Diseases. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Collum J, Jones RH, Lynham A, Hirst J. Leontiasis Ossea: A Presentation of Hyperparathyroidism in an Indigenous Australian Man Secondary to Chronic Renal Failure. J Oral Maxillofac Surg 2013; 71:56-61. [DOI: 10.1016/j.joms.2012.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 04/02/2012] [Accepted: 04/05/2012] [Indexed: 11/26/2022]
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13
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Woo SB. Nonodontogenic Intraosseous Lesions. ORAL PATHOLOGY 2012:382-431. [DOI: 10.1016/b978-1-4377-2226-0.00016-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Lerman MA, Do C, Gunaratnam L, Kulkarni C, Tucker K, Woo SB. Localized mandibular enlargement in end-stage renal disease: two case reports and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2011; 113:384-90. [PMID: 22676829 DOI: 10.1016/j.tripleo.2011.04.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 04/27/2011] [Accepted: 04/30/2011] [Indexed: 11/15/2022]
Abstract
Enlargement of the jaws is an infrequently reported complication of chronic kidney disease mineral and bone disorder (CKD-MBD). Two cases of localized mandibular swellings in young patients with histories of end-stage renal disease are discussed with a review of the literature. Although 17 of the first 19 cases that were reported exhibited diffuse enlargement, these reports increase the number of localized swellings to 8 and support the contention that localized expansion of the jaws as a manifestation of CKD-MBD is more common than originally recognized.
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Affiliation(s)
- Mark A Lerman
- Harvard School of Dental Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02120, USA.
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Thomas S, Nair P, Hegde K, Neelakantan S. A bilaterally recurring exophytic mass on the lower jaw. BMJ Case Rep 2011; 2011:bcr.09.2010.3362. [PMID: 22689854 DOI: 10.1136/bcr.09.2010.3362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Brown tumour is a rare focal giant-cell lesion that arises as a direct result of the effect of parathyroid hormone on bone tissue in patients with hyperparathyroidism (HPT). The lesions localise in areas of intense bone resorption, and the bone defect becomes filled with fibroblastic tissue. It can affect the mandible, maxilla, clavicle, ribs and pelvic bones. Therefore, diagnosis requires a systemic investigation for lesion differentiation. The authors present a case of a 27-year-old woman, with a rare case of brown tumour of mandible due to HPT secondary to osteomalacia. The lesion showed a tendency to recur even after excision till her parathyroid levels became normal.
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Affiliation(s)
- Shaji Thomas
- Department of Oral and Maxillofacial Surgery, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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16
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de Lacerda JCT, Gomes CC, e Oliveira CDS, Gomez RS. Osteodystrophy and brown tumour causing localised jaw enlargement. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1752-248x.2008.00031.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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17
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Rodriguez ED, Bluebond-Langner R, Spivak AM, Eisig SB. Surgical management of maxillofacial uremic osteodystrophy: a case report. J Oral Maxillofac Surg 2007; 65:1825-9. [PMID: 17719406 DOI: 10.1016/j.joms.2006.06.277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2005] [Revised: 02/22/2006] [Accepted: 06/14/2006] [Indexed: 11/30/2022]
Affiliation(s)
- Eduardo D Rodriguez
- Division of Plastic, Reconstructive and Maxillofacial Surgery, R. Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD 21201-1595, USA.
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Bots CP, Poorterman JHG, Brand HS, Kalsbeek H, van Amerongen BM, Veerman ECI, Nieuw Amerongen AV. The oral health status of dentate patients with chronic renal failure undergoing dialysis therapy. Oral Dis 2006; 12:176-80. [PMID: 16476040 DOI: 10.1111/j.1601-0825.2005.01183.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to compare the oral health status of chronic renal failure (CRF) patients on renal replacement therapy with a matched reference population. DESIGN Cross-sectional study. SUBJECTS Forty-two dentate CRF patients--aged 25-52 years old--were matched with a reference group of 808 dentate subjects. METHODS The oral health was assessed using decayed missing filled (DMF) indices, simplified oral hygiene index and periodontal status. An oral health questionnaire was used to assess self-reported dental problems. Student t-tests and chi-square tests were performed to compare the CRF patients with the controls. RESULTS All index-scores in the CRF patients were comparable with the controls except for number of teeth covered with calculus that was significantly higher (P < 0.05) in CRF patients (4.1 +/- 2.6) than in controls (3.0 +/- 2.9). The self-reported oral health questionnaire revealed a trend for increased temporomandibular complaints in CRF patients (16.7%vs 5.7% in controls; P = 0.06) as well as bad taste (31.0%vs 6.8% in controls, P = 0.08). CONCLUSIONS For most dental aspects, the oral health of CRF patients is comparable with controls.
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Affiliation(s)
- C P Bots
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Vrije Universiteit and Universitiet van Amsterdam, The Netherlands.
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Hata T, Irei I, Tanaka K, Nagatsuka H, Hosoda M. Macrognathia secondary to dialysis-related renal osteodystrophy treated successfully by parathyroidectomy. Int J Oral Maxillofac Surg 2006; 35:378-82. [PMID: 16360304 DOI: 10.1016/j.ijom.2005.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2005] [Revised: 07/29/2005] [Accepted: 08/19/2005] [Indexed: 11/28/2022]
Abstract
Renal osteodystrophy (ROD) is one of the most common complications affecting patients with chronic renal failure both before and after the initiation of maintenance dialysis, but macrognathia secondary to ROD is rare. Usually, enlarged jaws due to ROD do not return to their normal contours after the treatment of hyperparathyroidism. To the authors' knowledge, this article describes the second case of macrognathia secondary to dialysis-related ROD treated successfully by parathyroidectomy. Immunohistochemical study of the maxilla confirmed that parathyroidectomy could stop maladaptive parathyroid hormone stimulation, which leads not only to the formation of osteoblastic progenitors that become fibroblast-like cells but also to osteoclast formation.
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Affiliation(s)
- T Hata
- Department of Oral Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki-shi, Okayama 701-0192, Japan.
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20
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Proctor R, Kumar N, Stein A, Moles D, Porter S. Oral and dental aspects of chronic renal failure. J Dent Res 2005; 84:199-208. [PMID: 15723858 DOI: 10.1177/154405910508400301] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present article reviews, in detail, the current knowledge of the oral and dental aspects of chronic renal failure (CRF). Worldwide, increasing numbers of persons have CRF; thus, oral health care staffs are increasingly likely to provide care for patients with such disease. Chronic renal failure can give rise to a wide spectrum of oral manifestations, affecting the hard or soft tissues of the mouth. The majority of affected individuals have disease that does not complicate oral health care; nevertheless, the dental management of such individuals does require that the clinician understand the multiple systems that can be affected. The clinician should also consider the adverse side-effects of drug therapy and appropriate prescribing, in view of compromised renal clearance.
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Affiliation(s)
- R Proctor
- Oral Medicine, Division of Maxillofacial Diagnostic, Medical & Surgical Sciences, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, 256 Gray's Inn Road, London WC1X 8LD, UK
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21
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Affiliation(s)
- Roger R Throndson
- Oral and Maxillofacial Surgery, Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0531, USA.
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Kalyvas D, Tosios KI, Leventis MD, Tsiklakis K, Angelopoulos AP. Localized jaw enlargement in renal osteodystrophy: report of a case and review of the literature. ACTA ACUST UNITED AC 2004; 97:68-74. [PMID: 14716259 DOI: 10.1016/s1079-2104(03)00381-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Renal osteodystrophy is a common long-term complication of end-stage renal disease. Involvement of the jaws is common and radiographic alterations are often one of the earliest signs of chronic renal disease. However, marked enlargement of the jaws is a rare complication of renal osteodystrophy. A case of localized asymptomatic enlargement of the mandible in a 38-year-old woman with chronic renal failure is presented. The clinical, radiographic, and histological findings were consistent with renal osteodystrophy. To our knowledge, this is the third case of localized mandibular enlargement of renal osteodystrophy reported in the English-language literature.
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Affiliation(s)
- Demos Kalyvas
- Department of Oral Pathology and Surgery, Dental School, University of Athens, Greece.
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23
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Kerr AR. Update on renal disease for the dental practitioner. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 92:9-16. [PMID: 11458240 DOI: 10.1067/moe.2001.115976] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- A R Kerr
- Department of Oral Medicine, New York University College of Dentistry, New York, NY 10010, USA
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