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Secondary hyperparathyroidism causing increased jaw bone density and mandibular pain: a case report
Thomas Aerden1, Koenraad Grisar1, Margaux Nys1
1OMFS-IMPATH Research Group, Department Imaging & Pathology, Faculty of Medicine, University Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium.
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
|January 10, 2018
Summary
Secondary hyperparathyroidism due to vitamin D deficiency can manifest as increased mandibular cortical density. Treatment with vitamin D supplements resolved the patient's chronic jaw pain.
Area of Science:
- Endocrinology
- Oral and Maxillofacial Radiology
- Bone Metabolism
Background:
- Recurrent mandibular pain can be challenging to diagnose.
- Radiographic findings of increased cortical density in the mandible are uncommon.
Observation:
- A 32-year-old male presented with chronic mandibular pain.
- Imaging revealed increased mandibular cortical density and metabolic hyperactivity.
- Bone biopsy showed no inflammation or atypia.
Findings:
- Endocrinologic evaluation diagnosed secondary hyperparathyroidism secondary to hypovitaminosis D.
- This is a rare presentation, as secondary hyperparathyroidism typically causes lamina dura loss and a ground-glass appearance.
Implications:
- Increased cortical density in the jaw may indicate underlying metabolic bone disease.
- Comprehensive evaluation including imaging, biopsy, and blood analysis is crucial for diagnosing orofacial pain causes.
- Early diagnosis and treatment of hypovitaminosis D can alleviate symptoms associated with secondary hyperparathyroidism.
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