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01.04.2014 | Original Article

Severe secondary hyperparathyroidism and panoramic radiography parameters

verfasst von: João César Guimarães Henriques, Julio Cezar de Melo Castilho, Reinhilde Jacobs, José Benedito Oliveira Amorim, Rafaela Rangel Rosa, Caio Vinícius Bardi Matai

Erschienen in: Clinical Oral Investigations | Ausgabe 3/2014

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Abstract

Objectives

Renal osteodystrophy (RO) are skeletal abnormalities seen in patients with secondary hyperparathyroidism (SHPT). This study aims to evaluate the effects of RO using panoramic radiography parameters. Furthermore, the correlation between these parameters and parathyroid hormone (PTH) levels was tested.

Materials and methods

Qualitative (mandibular cortical index/trabecular bone pattern) and quantitative parameters (mental index/calcification and resorption foci) were applied from panoramic radiographs of chronic kidney disease (CKD) patients and controls. Frequency distribution and descriptive analysis were used to compare the results of both groups. Spearman’s correlation coefficient evaluated the correlation between serum PTH levels of CKD patients and the radiographic parameters. Intra- and interobserver agreement was tested using the intraclass correlation coefficient and kappa index.

Results

Intra- and interobserver agreement was respectively excellent (0.81–1.00) and good (0.61–0.80). Qualitative parameters demonstrate significant difference compared with the control group. Mean mental index was lower in patients with CKD (3.17 ± 1.35 mm), but the difference was not significant. Calcification/resorption foci (3.63 ± 2.07) of CKD patients were significantly more present than in the control group (p = 0.0001). PTH levels were correlated with mental index, mandibular cortical index and trabecular bone pattern (respectively, 0.0034, 0.0315, and 0.0370).

Conclusions

RO presented a number of characteristic bone metabolic effects in the jaws that could be observed on panoramic radiographs. Radiographs of CKD patients demonstrate significantly more calcification and resorption.

Clinical relevance

The mental index, mandibular cortical index, and trabecular bone pattern are good parameters for evaluating the effects of RO on severe secondary hyperparathyroidism.

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Titel: Severe secondary hyperparathyroidism and panoramic radiography parameters
verfasst von: João César Guimarães Henriques
Julio Cezar de Melo Castilho
Reinhilde Jacobs
José Benedito Oliveira Amorim
Rafaela Rangel Rosa
Caio Vinícius Bardi Matai
Publikationsdatum: 01.04.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 3/2014
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-013-1025-0

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Severe secondary hyperparathyroidism and panoramic radiography parameters