RESUMO
OBJECTIVE: The aim was to correlate radiomorphometric indices and biochemical analyses as an auxiliary method in bone evaluation in male and female patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and controls. MATERIALS AND METHODS: Nine radiomorphometric indices and four biochemical parameters were obtained: mental index (MI), height at the mental foramen, total mandibular height (THM), panoramic mandibular index (PMI), original height of the mandible, alveolar bone resorption, distance from the mental foramen to the alveolar bone crest (MF-ABC), mandibular cortical index (MCI), trabecular bone pattern, parathyroid hormone (PTH), calcium (Ca), phosphorus (P), and Ca × P product (Ca × P). STATISTICAL ANALYSIS: The Mann-Whitney U-test, chi-squared test, and Spearman's correlation were applied at a significance level of 95%. RESULTS: There was a moderate negative and significant correlation between MI, PMI, and PTH in female patients with CKD-MBD as well as between THM, MF-ABC, and Ca × P. The MCI and trabecular bone pattern indicated altered bone quality in male patients. CONCLUSIONS: The radiomorphometric evaluation was an auxiliary, noninvasive method to detect possible alterations in the cortex and mandibular bone trabeculation in male and female patients with CKD-MBD.
RESUMO
The brown tumor is a bone lesion that may affect the entire skeleton, including the maxillary bones. These tumors are characterized as focal giant cell lesions that may be associated with primary or secondary hyperparathyroidism (HPT). Brown tumors are invasive in some cases and an association with chronic renal failure (CRF) has been reported. With the aim to facilitate the differential diagnosis of bone lesions that may affect dialysis patients, this paper describes a case of brown tumor in a 36- year old patient with CRF, secondary HPT carrier, who had a lesion on the right maxilla for approximately five months.
O tumor marrom é uma lesão óssea que pode acometer todo o esqueleto, inclusive os ossos maxilares. Apresenta-se como uma lesão focal de células gigantes associada ao hiperparatireoidismo (HPT) primário ou secundário; é invasiva em alguns casos e pode associar-se à insuficiência renal crônica (IRC). O presente trabalho descreve um caso de tumor marrom em uma paciente de 36 anos com insuficiência renal crônica (IRC), portadora de HPT secundário, que apresentava lesão, com duração de aproximadamente cinco meses, localizada na maxila direita, com o objetivo de auxiliar o diagnóstico diferencial das lesões ósseas que podem afetar pacientes dialíticos.
RESUMO
Aim: To evaluate the oral conditions of patients with chronic kidney disease undergoing dialysisand to determine the influence of dialysis duration and bone metabolism on the prevalence andseverity of the alterations found. Methods: The simplified oral hygiene index (OHI-S), prevalenceof dental caries (decayed, missing filled teeth index, DMFT), and the periodontal screening andrecording (PSR) index were evaluated in 154 patients. Parathyroid hormone (PTH), calcium,phosphorus and urea measurements, as well as panoramic radiographs, were obtained from allpatients. To evaluate the effect of duration of dialysis treatment on oral health, the patients weredivided into two groups: (1) <5 years and (2) > 5 years. Regarding blood levels of PTH, patientswere divided into three groups: (1) 0-149 pg/mL, (2) 150-584 pg/mL, and (3) >585 pg/mL. TheOHI-S identified the accumulation of biofilm and calculus around the teeth. Results: Gingivalinflammation was found in 100% of dentate patients, with 2 being the predominant PSR score(72.3%). The DMFT index was high (17.52). Dental calculus was the most common radiographicfinding (70.8%). No significant correlation was observed between dialysis duration, biochemicalalterations, and oral health. Conclusions: Most patients undergoing dialysis presented precariousoral hygiene, periodontal inflammation, and bone alterations. However, these manifestationswere not influenced by the duration of dialysis or bone metabolism.
