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Evaluation of renal osteodystrophy in the dental clinic by assessment of mandibular and phalangeal cortical indices

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Abstract

Objectives

Secondary hyperparathyroidism (SHPT) is a disease that affects patients with chronic kidney disease, and is characterized by mineral disturbance and bone loss, known as renal osteodystrophy. The aim of this study was to assess the validity of using intraoral phosphor storage plates to take radiographs of the middle phalanges to evaluate bone loss resulting from SHPT during follow-up of these patients.

Methods

The sample consisted of 24 patients with chronic kidney disease, 12 with parathyroid hormone (PTH) levels ≥500 pg/ml, and 12 with PTH levels <500 pg/ml, who underwent hemodialysis weekly. For each patient, a panoramic radiograph and digital radiographs of the ring, index, and middle fingers of both hands were taken. The Mandibular Cortical Index (MCI) and the Trabecular Bone Pattern Index (TBP) were applied to the panoramic radiographs, while the Phalangeal Cortical Index (PCI) was applied to the digital radiographs of the phalanges. Three evaluators performed all analyses.

Results

Significant correlations were found between the PTH levels and the MCI (p = 0.023), the PCI (p = 0.039) and the TBP index (p = 0.032). These parameters were also significantly interrelated (MCI × PCI = 0.001; MCI × TBP = 0.004 and PCI × TBP = 0.009). The PCI was shown to have the highest correlation with PTH levels.

Conclusion

In patients with chronic renal disease, it is clinically relevant to use panoramic and digital radiographs using intraoral storage plates to assess a number of quantitative parameters that can be linked to PTH levels.

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Acknowledgements

This research was conducted with financial assistance from the Research Support Foundation of the State of Minas Gerais—FAPEMIG.

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Authors and Affiliations

  1. Diagnosis and Stomatology Department, Universidade Federal de Uberlândia, Avenida Pará, 1720. Bloco 2G, Sala 08. Bairro Umuarama, Uberlândia, Minas Gerais, 38405-320, Brazil

    Bruna Corrêa Massahud & João César Guimarães Henriques

  2. Oral Imaging Center, Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000, Louvain, Belgium

    Reinhilde Jacobs

  3. Faculdade de Odontologia, Campus de São José dos Campos, Universidade Estadual Paulista Julio de Mesquita Filho, Avenida Engenheiro Francisco José Longo, No. 777-Bairro: Jardim São Dimas, São Paulo, 12245-000, Brazil

    Rafaela Rangel Rosa & Caio Vinícius Bardi Matai

Authors
  1. Bruna Corrêa Massahud
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  2. João César Guimarães Henriques
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  3. Reinhilde Jacobs
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  4. Rafaela Rangel Rosa
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  5. Caio Vinícius Bardi Matai
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Corresponding author

Correspondence to João César Guimarães Henriques.

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Conflict of interest

Authors Bruna Corrêa Massahud, João César Guimarães Henriques, Reinhilde Jacobs, Rafaela Rangel Rosa and Caio Vinícius Bardi Matai declare that they have no conflict of interest.

Human rights statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

Animal rights statement

This article does not contain any studies with animal subjects performed by any of the authors.

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Massahud, B.C., Henriques, J.C.G., Jacobs, R. et al. Evaluation of renal osteodystrophy in the dental clinic by assessment of mandibular and phalangeal cortical indices. Oral Radiol 34, 172–178 (2018). https://doi.org/10.1007/s11282-017-0302-z

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  • DOI: https://doi.org/10.1007/s11282-017-0302-z

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