| Theme | Oral Diseases and Oral Care in Dialysis Patients | |
|---|---|---|
| Title | Skeletal manifestations observed in jaws of long term hemodialysis patients | |
| Publish Date | 2011/06 | |
| Author | Makoto Tsuchimochi | Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata |
| [ Summary ] | Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a new concept encompassing all disturbances related to mineral and bone metabolism caused by chronic kidney disease (CKD). Renal osteodystrophy is one component of CKD-MBD which is confined to mineral and bone disorders. Skeletal abnormalities are frequently observed in chronic hemodialysis patients. The most common radiographic findings are relevant to secondary hyperparathyroidism in which bone resorption, osteosclerosis, and osteomalacia are observed. Radiographic changes are also seen in the mandible and maxilla with the following characteristic findings; loss of lamina dura, disappearance of the mandibular canal and cortical bone and loss of trabecular pattern. Thirty seven patients whose conditions were maintained with hemodialysis therapy were involved. In our skeletal scintigraphic study, accumulation of Tc-99m MDP was evaluated by analyzing the semi-quantitative bone to soft tissue ratio (B/St ratio). Regions of interest (ROI) including the calvarium, mandible, maxilla, and right cervical soft tissue were established by analysis of this ratio. Radiographic examination revealed changes in bone tissue in 46 % of 37 patients studied. Bone scintigrams revealed abnormal uptake in 73 %. There is a significant positive correlation between the 4hr B/St ratio and PTH (parathyroid hormone) levels (r=0.82, p<0.001). Bone scintigraphy is a sensitive diagnostic modality to detect changes in bone structure in renal osteodystrophy patients. |
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