Oro-dental pathologies in acromegaly
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Oro-dental pathologies (ODP) such as enlargement of the tongue, mandibular prognathism, and spaced teeth are characteristic features of acromegaly. Their frequency of occurrence during the course of the disease is largely unresolved. Purpose of this study was to assess ODP and oro-dental treatments in patients with acromegaly with regard to the length of the diagnostic process, tumor histology, and quality of life (QoL).
Single-center retrospective survey study using questionnaires on dental symptoms, diagnostic process, and treatment in patients with acromegaly operated on a growth hormone-secreting pituitary adenoma. The association between ODP and QoL was assessed using the Short-Form 36 (SF-36) Health Survey.
145/314 patients completed the questionnaires. 80.7% were affected by any ODP, most frequently enlargement of the tongue (57.9%), spaced teeth (42.8%), mandibular growth (24.1%), and mandibular prognathism (22.1%). ODP were significantly more frequent in patients with sparsely vs. densely granulated adenomas (p = 0.045). Early diagnosis within 2 years was associated with significantly fewer ODP than later diagnosis (68.5 vs. 87.2%, p = 0.009). Treatments included dental crowns (16.6%), dental bridges (12.4%), dental implants (9.7%), dental prostheses (3.4%), orthodontal (i.e., braces, 6.9%), and surgical correction of the teeth (2.1%). Physical QoL was significantly lower in patients with ODP than in those without (p = 0.014).
In our large series of patients, four of five patients were affected by ODP at any time during the course of the disease. The results highlight the importance of early identification and treatment of oro-dental problems in patients with acromegaly as hallmarks of the disease.
KeywordsAcromegaly Teeth Oro-dental Prognathism Quality of life
The data were in part collected for the doctoral thesis of Johannes Kohlmann. The study was supported in part by an independent investigator-initiated grant from Ipsen, Germany. Editorial support and linguistic corrections were provided by J. Sauer, DP-Medsystems, Germany, and funded by Ipsen, Germany.
I.K.-A., J.K., U.H., M.B., and S.S. designed the study. I.K.-A., J.K. and S.S. collected the data. R.B. provided the histological analysis. B.K., I.K.-A., and S.S. conducted the statistical data analysis. All authors critically discussed the results of the study and participated in the drafting of the manuscript.
Compliance with ethical standards
Conflict of interest
I.K.-A., B.K., M.B., and S.S. have received speakers’ honoraria, travel, and research grants from Ipsen Pharma, Novartis Pharma, CHIASMA, and/or Pfizer. The remaining authors declare that they have no conflict of interest.
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