Radiographic changes of the jawbones in end stage renal disease

Thirty-eight patients with a history of end stage renal disease (ESRD) were evaluated with panoramic and periapical radiographs for changes in lamina dura, trabecular pattern, radiographic density, and pulp chamber size, as well as the presence of radiolucent lesions not associated with the roots of teeth. Partial or complete loss of lamina dura, delicate of absent trabecular patterns, and an overall granular or chalky white appearance associated with an increase in radiographic density were the most common alterations. These tended to occur together and were most easily observed in the lower molar area superior to the mandibular canal. Radiolucent lesions not associated with the roots of teeth, expansion of alveolar ridges, and radiographic loss of the cortical borders of the maxillary sinus, nasal floor, and mandibular canal were less common but were occasionally noted. Multiple correlation coefficients between radiographic changes and selected biomedical patient data were obtained by computer analysis, and their significance discussed. The pathogenesis of end stage renal disease was also reviewed.