Marginal periodontal pathology in patients with pituitary disorders
Ileana Duncea1, Carmen Georgescu1 & Ioana Duncea2
Periodontal changes are induced by hormonal alterations through soft tissue oedema, inflammation, demineralization or abnormal periosteal development of the alveolar bones.
Objectives: The purpose of the present work was to evaluate the frequency, severity and type of periodontal disease in subjects with previously diagnosed and non-treated pituitary disorders.
Patients and methods: Twenty-five subjects (21 women and 4 men) aged 44.7 years old were enrolled in the present study. Of the 25 patients, 10 suffered from clinical non-functional pituitary adenoma, 9 were diagnosed with acromegaly, 3 had a prolactinoma and in 3 a severe pituitary insufficiency was diagnosed. The endocrine disorder was diagnosed based on basal and dynamic hormonal tests, nuclear magnetic resonance image and visual champ evaluation. In addition, all patients were subjected to a thorough dental examination completed by orto-pan-tomography imaging. Following oral hygiene indices were calculated: the Green Vermillon index (OHIS), the Russel periodontal index (PI) and the OMS index of periodontal therapy request (CPITN).
Results: All subjects presented different forms of chronic periodontal pathology. Dystrophic periodontal disease was the most prevalent form, followed by superficial chronic periodontal disease. Severe periodontal disease including marked gingival retraction and periodontal pockets with purulent secretion was diagnosed in three patients. Patients had a mean OHIS of 3.54 suggesting an unsatisfactory oral hygiene; correspondingly, 12% of patients were advised to improve the oral hygiene, 72% needed professional dental care and antibacterial therapy. In 16%, surgical periodontal therapy was advised.
Conclusions: All 25 patients with pituitary diseases had periodontal pathology suggesting that this endocrine pathology may represent a risk factor for periodontal disease. Prevention and therapy of periodontal changes in these patients need careful oral personal hygiene and regular professional dental care.