Hyperparathyroidism (generalized osteitis fibrosa)

Hyperparathyroidism, although a rare disease, is particularly important to the oral surgeon because of the possible oral manifestations. Etiologically, the disease is due to an increase in secretion of the hormone of the parathyroid gland. Two varieties, primary or secondary hyperparathyroidism, may cause the various entities of the disease. The disease occurs mainly between the ages of 40 and 60. Many cases of hyperparathyroidism may go unrecognized until manifestations such as bone involvements or nephrolithiases occur, because the disease can be proved only by laboratory determination. The roentgenographic picture is not distinctive for it may simulate any number of diseases. Histopathologically, the normal bone marrow is replaced by fibrous tissue. Here, again, this alteration may be present in other diseases. Treatment is surgical removal of the tumor of the parathyroid gland or glands. A case report of hyperparathyroidism with skeletal as well as kidney involvement is presented. It was the oral complaints of the patient that made possible the diagnosis of hyperparathyroidism. The close cooperation between the dental and medical professions was necessary for the successful treatment of this patient. The treatment of the oral symptoms of hyperparathyroidism without an understanding of the underlying general disease would be futile.