Endocrine Abstracts

Introduction: Primary Hyperparathyroidism usually presents as bone disease, renal or with Gastro Intestinal Symptoms. Dental Symptoms as primary or presenting manifestations are rare. We report two patients who presented with edentulous jaw in young age, which resulted in investigations leading to the diagnosis for primary hyperparathyroidism.

Material and methods: We report two patients operated in a tertiary referral Centre from Jan 2017–Dec 2017 for PHPT with Edentulous jaw. We describe the clinical case and surgical findings of these two patients.

Results: First patient was a 30 year old lady had loosening and falling all teeth suddenly within 2 months, investigated had hypercalcemia of 13 mg/dl and had concordant Left Inferior parathyroid adenoma on USG and MIBI Scan. She underwent uneventful focused parathyroid with IOPTH monitoring and on follow up norm calcemic. Second patient was a 45 year old lady who had loosing and falling of most of the teeth with bone pains, investigated and found to have hypercalcemic crisis of 17 mg/dl. She had an aorta pulmonary window parathyroid Adenoma on functional and anatomic imaging. She was treated with hydration, Calcitonin and bisphosphonates and operated in the same admission and underwent sternotomy and focused parathyroidectomy with IOPTH monitoring and on follow up normocalcemic.

Discussion: Dental manifestations are rare but can be the first symptom of PHPT. Severe osteoporosis can manifest as falling of teeth when resorption of jaw occurs due to osteoporosis and tooth become loose and fall off.