The Evaluation of Correlation Between Serum PTH and Dentoskeletal Changes in Panoramic Imaging of Hemodialysis Patients

  This study aimed to investigate the relationship between serum levels of PTH and dental and bone changes in the panoramic view of hemodialysis patients.

  Out of 236 patients with end-stage kidney disease (ESKD) who were hospitalized in two hemodialysis centers, 68 ones were selected and concerning their PTH serum levels, they were assigned to case group (PTH > 300 pg/mL) and control group (150 < PTH < 300 pg/mL). Patients in both groups had undergone dialysis for at least 6 months. After intraoral and extraoral examinations, panoramic radiography was performed for patients who hadn’t taken any panoramic radiograph within 6 months prior to our study. All radiographs were evaluated for DMFT (decayed, missing and filled teeth) index, bone resorption, periodontal ligament (PDL), lamina dura, mandibular cortical thickness, bone granular pattern, pulp and periapical lesion and giant cell (brown) tumor. The results were analyzed by Chi square statistical tests. Significant level (P value) of test was considered less than .05.

Among the eight variables, there was only a significant statistical difference between the case and control groups in the granular bone pattern and inferior mandibular cortex thickness.

High levels of PTH in hemodialysis patients with secondary hyperparathyroidism can significantly change the trabecular alveolar bone pattern to a granular bone pattern. It also dramatically decreases the thickness of the inferior mandibular cortex. The findings of this study could influence the dental treatment plans for ESKD patients and help in early diagnosis of osteoporosis in patients on dialysis with secondary hyperparathyroidism