Cortese E, Scatà E, Basano L
Divisione di Odontoiatria e Stomatologia, Ospedale Mauriziano Umberto I, Torino.
Minerva Stomatol. 1994 Jun;43(6):293-9.
The authors illustrate a case report of Paget's disease in an exclusively cranio-facial localisation. Paget's disease is a dystrophy of an osteo-condensing type. Excess bone remodelling activity, due primarily to hyperclastic hyperactivity, leads to accelerated resorption and excess tissue formation. This marked alteration of the metabolism causes the hypertrophy of the bones involved, with zones of greater density and increased vascularisation. Its clinical manifestations include morphological deformations and painful symptoms in the areas affected. Complications may include pathological fractures, medullary or radicular compression, heart failure (rare), sarcomatous transformation (approximately 1% of cases). The case reported here describes a 70-year-old who was admitted to the out-patient clinic of the Odontostomatological Division of the Ospedale Mauriziano in Turin for a dental check up. The patient had had 6 teeth removed during the past 2 weeks in a private clinic. At the time of the control a mucous crater was present, also involving the underlying bone, at the level of the extracted 2.6 tooth. The patient had kept the teeth which had been removed some of which showed that the roots were surrounded by alveolar bone. A dental panoramic x-ray and cranial x-ray were performed using 3 projections and showed the remodelling of the cranial theca and upper jaw. The suspicion of Paget's disease was confirmed by hematochemical tests, bone scintigraphy with calcium phosphate and by the histologic examination of the alveolar bone fragments adhering to the root surface of the extracted teeth.(ABSTRACT TRUNCATED AT 250 WORDS)
作者阐述了一例仅累及颅面部的佩吉特病病例报告。佩吉特病是一种骨致密型营养不良。主要由于破骨细胞活性亢进导致的过度骨重塑活动,会引起加速吸收和过多的组织形成。这种代谢的显著改变会导致受累骨骼肥大,出现密度更高和血管增多的区域。其临床表现包括受累区域的形态变形和疼痛症状。并发症可能包括病理性骨折、髓腔或神经根受压、心力衰竭(罕见)、肉瘤样变(约1%的病例)。此处报告的病例描述了一名70岁患者,因牙科检查入住都灵毛里齐亚诺医院口腔颌面科门诊。该患者在过去2周内于一家私人诊所拔除了6颗牙齿。在复查时,在拔除的2.6牙水平处存在一个黏膜溃疡,也累及下方的骨质。患者保留了已拔除的牙齿,其中一些显示牙根被牙槽骨包围。使用3种投照方式进行了牙科全景X线检查和颅骨X线检查,显示颅盖和上颌骨有重塑。通过血液化学检查、磷酸钙骨闪烁显像以及对附着在拔除牙齿牙根表面的牙槽骨碎片进行组织学检查,证实了佩吉特病的怀疑。(摘要截选至250字)