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Published in: Calcified Tissue International 2/2021

01-08-2021 | Hypophosphatemic Rickets | Original Research

Characterization of Oral Health Status in Chilean Patients with X-Linked Hypophosphatemia

Authors: Alejandro Marin, Pilar Morales, Macarena Jiménez, Eugenia Borja, Danisa Ivanovic-Zuvic, Michael T. Collins, Pablo Florenzano

Published in: Calcified Tissue International | Issue 2/2021

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Abstract

X-Linked Hypophosphatemia (XLH) is the most common cause of inherited hypophosphatemic rickets. Dental involvement, including spontaneous abscesses and/or fistulae, is an important part of the disease and has not been completely defined, especially in cohorts from developing countries. To describe oral health status in a cohort of Chilean patients with XLH and explore its correlation with biochemical presentation and treatment, we conducted a cross-sectional observational study of patients with PHEX mutation-confirmed XLH. All patients had an oral clinical exam, radiographic evaluation; clinical and biochemical data were obtained to determine their association with oral features. Twenty-six patients were included, 77% adults and 23% children. Most adults (89%) had past or current dental pulp pathology (abscesses and/or fistulae). Pulpal chamber enlargement and radiolucent apical lesions were common radiological features (94 and 74%, respectively). In children, abscess and/or fistulae were also common (33%). Caries index, which was determined by dmft/DMFT, was higher than the Chilean national average. Early and long-term therapy with phosphate and activated vitamin D was associated with lower carious index and attachment loss. XLH patients frequently present with high pulpal involvement and carious index. Conventional therapy was associated with lower carious index and attachment loss. These data highlight the importance of early and periodical dental care in order to prevent dental damage and assure a good quality of oral health for XLH patients.
Literature
1.
go back to reference Carpenter TO, Imel EA, Holm IA, Jan de Beur SM, Insogna KL (2011) A clinician’s guide to X-linked hypophosphatemia. J Bone Miner Res 26:1381–1388CrossRef Carpenter TO, Imel EA, Holm IA, Jan de Beur SM, Insogna KL (2011) A clinician’s guide to X-linked hypophosphatemia. J Bone Miner Res 26:1381–1388CrossRef
2.
go back to reference Carpenter TO (2012) The expanding family of hypophosphatemic syndromes. J Bone Miner Metab 30:1–9CrossRef Carpenter TO (2012) The expanding family of hypophosphatemic syndromes. J Bone Miner Metab 30:1–9CrossRef
3.
go back to reference Marcucci G, Masi L, Ferrarì S, Haffner D, Javaid MK, Kamenický P, Reginster JY, Rizzoli R, Brandi ML (2018) Phosphate wasting disorders in adults. Osteoporos Int 29:2369–2387CrossRef Marcucci G, Masi L, Ferrarì S, Haffner D, Javaid MK, Kamenický P, Reginster JY, Rizzoli R, Brandi ML (2018) Phosphate wasting disorders in adults. Osteoporos Int 29:2369–2387CrossRef
4.
go back to reference Hanisch M, Bohner L, Sabandal MMI, Kleinheinz J, Jung S (2019) Oral symptoms and oral health-related quality of life of individuals with x-linked hypophosphatemia. Head Face Med 15:8CrossRef Hanisch M, Bohner L, Sabandal MMI, Kleinheinz J, Jung S (2019) Oral symptoms and oral health-related quality of life of individuals with x-linked hypophosphatemia. Head Face Med 15:8CrossRef
5.
go back to reference Sabandal MM, Robotta P, Bürklein S, Schäfer E (2015) Review of the dental implications of X-linked hypophosphataemic rickets (XLHR). Clin Oral Investig 19:759–768CrossRef Sabandal MM, Robotta P, Bürklein S, Schäfer E (2015) Review of the dental implications of X-linked hypophosphataemic rickets (XLHR). Clin Oral Investig 19:759–768CrossRef
6.
go back to reference Connor J, Olear EA, Insogna KL, Katz L, Baker S, Kaur R, Simpson CA, Sterpka J, Dubrow R, Zhang JH, Carpenter TO (2015) Conventional therapy in adults with X-Linked hypophosphatemia: effects on enthesopathy and dental disease. J Clin Endocrinol Metab 100:3625–3632CrossRef Connor J, Olear EA, Insogna KL, Katz L, Baker S, Kaur R, Simpson CA, Sterpka J, Dubrow R, Zhang JH, Carpenter TO (2015) Conventional therapy in adults with X-Linked hypophosphatemia: effects on enthesopathy and dental disease. J Clin Endocrinol Metab 100:3625–3632CrossRef
7.
go back to reference Econs MJ (2015) Conventional therapy in adults with XLH Improves dental manifestations, but not enthesopathy. J Clin Endocrinol Metab 100:3622–3624CrossRef Econs MJ (2015) Conventional therapy in adults with XLH Improves dental manifestations, but not enthesopathy. J Clin Endocrinol Metab 100:3622–3624CrossRef
8.
go back to reference Cremonesi I, Nucci C, D’Alessandro G, Alkhamis N, Marchionni S, Piana G (2014) X-linked hypophosphatemic rickets: enamel abnormalities and oral clinical findings. Scanning 36:456–461CrossRef Cremonesi I, Nucci C, D’Alessandro G, Alkhamis N, Marchionni S, Piana G (2014) X-linked hypophosphatemic rickets: enamel abnormalities and oral clinical findings. Scanning 36:456–461CrossRef
9.
go back to reference Paredes SEY, Segato RAB, Moreira LD, Moreira A, Serrano KVD, Rodrigues CT, Almeida LY, León JE (2018) Dentoalveolar abscesses not associated with caries or trauma: a diagnostic hallmark of hypophosphatemic rickets initially misdiagnosed as hypochondroplasia. Head Neck Pathol 12:604–609CrossRef Paredes SEY, Segato RAB, Moreira LD, Moreira A, Serrano KVD, Rodrigues CT, Almeida LY, León JE (2018) Dentoalveolar abscesses not associated with caries or trauma: a diagnostic hallmark of hypophosphatemic rickets initially misdiagnosed as hypochondroplasia. Head Neck Pathol 12:604–609CrossRef
10.
go back to reference Foster BL, Ramnitz MS, Gafni RI, Burke AB, Boyce AM, Lee JS, Wright JT, Akintoye SO, Somerman MJ, Collins MT (2014) Rare bone diseases and their dental, oral, and craniofacial manifestations. J Dent Res 93:7S-19SCrossRef Foster BL, Ramnitz MS, Gafni RI, Burke AB, Boyce AM, Lee JS, Wright JT, Akintoye SO, Somerman MJ, Collins MT (2014) Rare bone diseases and their dental, oral, and craniofacial manifestations. J Dent Res 93:7S-19SCrossRef
11.
go back to reference Andersen MG, Beck-Nielsen SS, Haubek D, Hintze H, Gjørup H, Poulsen S (2012) Periapical and endodontic status of permanent teeth in patients with hypophosphatemic rickets. J Oral Rehabil 39:144–150CrossRef Andersen MG, Beck-Nielsen SS, Haubek D, Hintze H, Gjørup H, Poulsen S (2012) Periapical and endodontic status of permanent teeth in patients with hypophosphatemic rickets. J Oral Rehabil 39:144–150CrossRef
12.
go back to reference Endo I, Fukumoto S, Ozono K, Namba N, Tanaka H, Inoue D, Minagawa M, Sugimoto T, Yamauchi M, Michigami T, Matsumoto T (2008) Clinical usefulness of measurement of fibroblast growth factor 23 (FGF23) in hypophosphatemic patients: proposal of diagnostic criteria using FGF23 measurement. Bone 42:1235–1239CrossRef Endo I, Fukumoto S, Ozono K, Namba N, Tanaka H, Inoue D, Minagawa M, Sugimoto T, Yamauchi M, Michigami T, Matsumoto T (2008) Clinical usefulness of measurement of fibroblast growth factor 23 (FGF23) in hypophosphatemic patients: proposal of diagnostic criteria using FGF23 measurement. Bone 42:1235–1239CrossRef
13.
go back to reference World Hearth Organization (2013) Oral health surveys: basic methods. World Hearth Organization, Geneva World Hearth Organization (2013) Oral health surveys: basic methods. World Hearth Organization, Geneva
14.
go back to reference Soto L, Tapia R, Jara G, Rodríguez G, Urbina T (2007) Diagnóstico nacional de salud bucal del adolescente de 12 años y evaluación del grado de cumplimiento de los objetivos sanitarios de salud bucal 2000–2010. In: Ediciones Universidad Mayor Soto L, Tapia R, Jara G, Rodríguez G, Urbina T (2007) Diagnóstico nacional de salud bucal del adolescente de 12 años y evaluación del grado de cumplimiento de los objetivos sanitarios de salud bucal 2000–2010. In: Ediciones Universidad Mayor
15.
go back to reference Coyac BR, Hoac B, Chafey P, Falgayrac G, Slimani L, Rowe PS, Penel G, Linglart A, McKee MD, Chaussain C, Bardet C (2018) Defective mineralization in X-linked hypophosphatemia dental pulp cell cultures. J Dent Res 97:184–191CrossRef Coyac BR, Hoac B, Chafey P, Falgayrac G, Slimani L, Rowe PS, Penel G, Linglart A, McKee MD, Chaussain C, Bardet C (2018) Defective mineralization in X-linked hypophosphatemia dental pulp cell cultures. J Dent Res 97:184–191CrossRef
16.
go back to reference Biosse Duplan M, Coyac BR, Bardet C, Zadikian C, Rothenbuhler A, Kamenicky P, Briot K, Linglart A, Chaussain C (2017) Phosphate and vitamin D prevent periodontitis in X-linked hypophosphatemia. J Dent Res 96:388–395CrossRef Biosse Duplan M, Coyac BR, Bardet C, Zadikian C, Rothenbuhler A, Kamenicky P, Briot K, Linglart A, Chaussain C (2017) Phosphate and vitamin D prevent periodontitis in X-linked hypophosphatemia. J Dent Res 96:388–395CrossRef
17.
go back to reference Gamonal J, Mendoza C, Espinoza I, Muñoz A, Urzúa I, Aranda W, Carvajal P, Arteaga O (2010) Clinical attachment loss in Chilean adult population: first chilean national dental examination survey. J Periodontol 81:1403–1410CrossRef Gamonal J, Mendoza C, Espinoza I, Muñoz A, Urzúa I, Aranda W, Carvajal P, Arteaga O (2010) Clinical attachment loss in Chilean adult population: first chilean national dental examination survey. J Periodontol 81:1403–1410CrossRef
18.
go back to reference Ministerio de Salud de Chile (2017) Plan nacional de salud bucal 2018–2030. In: Santiago Ministerio de Salud de Chile (2017) Plan nacional de salud bucal 2018–2030. In: Santiago
19.
go back to reference Fresno MC, Jeldes G, Estay J, Martin J (2019) Prevalencia, severidad de caries dental y necesidad de tratamiento restaurador en escolares de 6 a 12 años de la provincia de Santiago, región metropolitana. Rev Clín Periodoncia Implantol Rehabil Oral 12:81–86CrossRef Fresno MC, Jeldes G, Estay J, Martin J (2019) Prevalencia, severidad de caries dental y necesidad de tratamiento restaurador en escolares de 6 a 12 años de la provincia de Santiago, región metropolitana. Rev Clín Periodoncia Implantol Rehabil Oral 12:81–86CrossRef
Metadata
Title
Characterization of Oral Health Status in Chilean Patients with X-Linked Hypophosphatemia
Authors
Alejandro Marin
Pilar Morales
Macarena Jiménez
Eugenia Borja
Danisa Ivanovic-Zuvic
Michael T. Collins
Pablo Florenzano
Publication date
01-08-2021
Publisher
Springer US
Published in
Calcified Tissue International / Issue 2/2021
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI
https://doi.org/10.1007/s00223-021-00841-4

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