Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Dental management of patients with X-linked hypophosphatemia

  • Lee, Bin-Na (Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University) ;
  • Jung, Hye-Yoon (Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University) ;
  • Chang, Hoon-Sang (Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University) ;
  • Hwang, Yun-Chan (Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University) ;
  • Hwang, In-Nam (Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University) ;
  • Oh, Won-Mann (Department of Conservative Dentistry, School of Dentistry and Dental Science Research Institute, Chonnam National University)
  • Received : 2016.06.30
  • Accepted : 2016.11.09
  • Published : 2017.05.31
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Abstract

X-linked hypophosphatemia (XLH) is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. A 14 year old male and a 38 year old female with XLH were referred to the Department of Conservative Dentistry for endodontic treatment. The dental findings were periapical abscesses without obvious trauma or caries. Conservative endodontic treatment was performed in teeth with pulp necrosis and abscess. In case 1, the treated teeth showed improvements in bone healing, without clinical symptoms. However, in case 2, the implants and the treated tooth showed hypermobility, and the final restoration was therefore postponed. Early diagnosis, periodic examinations, and communication with the patient's pediatrician are important in the dental management of patients with XLH.

Keywords

References

  1. Moreland LW. Rheumatology and immunology therapy (A to Z essentials): hypophosphatemic vitamin D resistant rickets. Springer; 2004. p428.
  2. Beltes C, Zachou E. Endodontic management in a patient with vitamin D-resistant rickets. J Endod 2012;38:255-258. https://doi.org/10.1016/j.joen.2011.10.025
  3. Souza MA, Soares Junior LA, Santos MA, Vaisbich MH. Dental abnormalities and oral health in patients with Hypophosphatemic rickets. Clinics(Sao Paulo) 2010;65:1023-1026.
  4. Pereira CM, de Andrade CR, Vargas PA, Coletta RD, de Almeida OP, Lopes MA. Dental alterations associated with X-linked hypophosphatemic rickets. J Endod 2004;30:241-245. https://doi.org/10.1097/00004770-200404000-00015
  5. Thomas MK, Demay MB. Vitamin D deficiency and disorders of vitamin D metabolism. Endocrinol Metab Clin North Am 2000;29:611-627. https://doi.org/10.1016/S0889-8529(05)70153-5
  6. Feng JQ, Clinkenbeard EL, Yuan B, White KE, Drezner MK. Osteocyte regulation of phosphate homeostasis and bone mineralization underlies the pathophysiology of the heritable disorders of rickets and osteomalacia. Bone 2013;54:213-221. https://doi.org/10.1016/j.bone.2013.01.046
  7. Koehne T, Marshall RP, Jeschke A, Kahl-Nieke B, Schinke T, Amling M. Osteopetrosis, osteopetrorickets and hypophosphatemic rickets differentially affect dentin and enamel mineralization. Bone 2013;53:25-33. https://doi.org/10.1016/j.bone.2012.11.009
  8. Murayama T, Iwatsubo R, Akiyama S, Amano A, Morisaki I. Familial hypophosphatemic vitamin D-resistant rickets: dental findings and histologic study of teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:310-316. https://doi.org/10.1067/moe.2000.107522
  9. Chaussain-Miller C, Sinding C, Septier D, Wolikow M, Goldberg M, Garabedian M. Dentin structure in familial hypophosphatemic rickets: benefits of vitamin D and Dental management in X-linked hypophosphatemia phosphate treatment. Oral Dis 2007;13:482-489. https://doi.org/10.1111/j.1601-0825.2006.01326.x
  10. Zambrano M, Nikitakis NG, Sanchez-Quevedo MC, Sauk JJ, Sedano H, Rivera H. Oral and dental manifestations of vitamin D-dependent rickets type I: report of a pediatric case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:705-709. https://doi.org/10.1067/moe.2003.116
  11. Baroncelli GI, Angiolini M, Ninni E, Galli V, Saggese R, Giuca MR. Prevalence and pathogenesis of dental and periodontal lesions in children with X-linked hypophosphatemic rickets. Eur J Paediatr Dent 2006;7:61-66.
  12. Douyere D, Joseph C, Gaucher C, Chaussain C, Courson F. Familial hypophosphatemic vitamin D-resistant ricketsprevention of spontaneous dental abscesses on primary teeth: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:525-530. https://doi.org/10.1016/j.tripleo.2008.12.003
  13. Opsahl Vital S, Gaucher C, Bardet C, Rowe PS, George A, Linglart A, Chaussain C. Tooth dentin defects reflect genetic disorders affecting bone mineralization. Bone 2012;50:989-997. https://doi.org/10.1016/j.bone.2012.01.010
  14. Holm IA, Nelson AE, Robinson BG, Mason RS, Marsh DJ, Cowell CT, Carpenter TO. Mutational analysis and genotype-phenotype correlation of the PHEX gene in X-linked hypophosphatemic rickets. J Clin Endocrinol Metab 2001;86:3889-3899. https://doi.org/10.1210/jcem.86.8.7761
  15. Imel EA, Gray AK, Padgett LR, Econs MJ. Iron and fibroblast growth factor 23 in X-linked hypophosphatemia. Bone 2014;60:87-92. https://doi.org/10.1016/j.bone.2013.12.001
  16. Resnick D. Implant placement and guided tissue regeneration in a patient with congenital vitamin D-resistant rickets. J Oral Implantol 1998;24:214-218. https://doi.org/10.1563/1548-1336(1998)024<0214:IPAGTR>2.3.CO;2
  17. Makitie O, Doria A, Kooh SW, Cole WG, Daneman A, Sochett E. Early treatment improves growth and biochemical and radiographic outcome in X-linked hypophosphatemic rickets. J Clin Endocrinol Metab 2003;88:3591-3597. https://doi.org/10.1210/jc.2003-030036
  18. Carpenter TO, Insogna KL, Zhang JH, Ellis B, Nieman S, Simpson C, Olear E, Gundberg CM. Circulating levels of soluble klotho and FGF23 in X-linked hypophosphatemia: circadian variance, effects of treatment, and relationship to parathyroid status. J Clin Endocrinol Metab 2010;95:E352-E357. https://doi.org/10.1210/jc.2010-0589
  19. Carpenter TO, Imel EA, Holm IA, Jan de Beur SM, Insogna KL. A clinician's guide to X-linked hypophosphatemia. J Bone Miner Res 2011;26:1381-1388. https://doi.org/10.1002/jbmr.340
  20. Tumen EC, Yavuz I, Tumen DS, Atakul F. Dental and histologic findings of X-linked hypophosphataemic vitamin D-resistant rickets: a case report. Int Dent Med Disord 2008;1:37-42.
  21. Seow WK. Diagnosis and management of unusual dental abscesses in children. Aust Dent J 2003;48:156-168. https://doi.org/10.1111/j.1834-7819.2003.tb00026.x

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