Background & Aims

X-linked hypophosphatemia (XLH) affects 5/1.000.000 inhabitants, with a genetic and hereditary cause associated with changes in phosphate metabolism. The pathophysiology of this disease is related to an increase in fibroblast growth factor 23 (FGF 23), which, when present in high quantities in the body, increases the excretion of phosphate via the kidneys.It causes joint and bone pain, stiffness, and decreased joint mobility. Furthermore, patients with XLH are more likely to develop osteoarthritis, which is a multifactorial degenerative joint disease. Orofacial pain encompasses any oral cavity and face pain, including temporomandibular disorder (TMD). The most common symptoms include restricted movement, headache, pre-auricular, ear, neck, or shoulder pain, and joint noises. It is the first study in the literature investigating the occurrence of TMD in XLH patients.

Methods

Sixteen patients, both sexes, aged between 06 and 56 years, were referred to be evaluated at the Dental Clinic of the School of Dentistry of the Tuiuti University of Paraná after receiving the XLH diagnostic from doctors of the Endocrinology Service, School of Medicine of the Federal University of Paraná. All patients signed the Free and Informed Consent Form (ICF) before data collection. The Research Ethics Committee approved the study under number CAAE 64318922.4.0000.8040 / 5.804.872. Patients under 18 and without the XLH comprobatory genetic test were excluded from the study. Two calibrated graduate students and one Ph.D. professor examined the patients’ clinical and radiographic condition. Bite-wings, periapical, and panoramic radiographs were taken. The “Diagnostic Criteria-Temporomandibular Disorders” (DC-TMD) and the “VAS” ruler were used as diagnostic tools for all patients.

Results

Six female patients were included in the study. Three (50%) of the six patients had arthralgia; 4 (66.6%) disc displacement with reduction, 1 (16.6%) disc displacement without reduction, 2 (33.3%) myalgia, and 1 (16, 6%) a headache due to DTM. Three patients (50%) had multiple dysfunctions, such as disc displacement with reduction, myalgia, and arthralgia. Only one female (16.6%) reported no temporomandibular joint pain.

Conclusions

XLH is a rare disease, with few studies in the dentistry field. The present study is the first in the literature describing a DTM condition related to XLH. Patients complain that dentists don’t know their systemic condition, and they have difficulty treating them accordingly. It was concluded that XLH patients have a high incidence of TMD, which leads to pain, reducing their quality of life.

References

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Presenting Author

Jose Stechman-Neto

Poster Authors

Jose Stechman Neto

Dr.

Tuiuti University of Parana

Lead Author

Gabrielle Gonçalves dos Santos

DDS

School of Dentistry, Tuiuti University of Paraná

Lead Author

Liliane Roskamp

PhD

School of Dentistry, Tuiuti University of Parana

Lead Author

Carolina Aguiar Moreira

PhD

School of Medicine, Federal University of Paraná

Lead Author

João Pedro Siewert Pereira

DDS

School of Dentistry, Tuiuti University of Paraná

Lead Author

Maria Carolina Botelho Pires de Campos

MSc

School of Dentistry, Tuiuti University of Parana

Lead Author

Reynaldo Todescan Jr

University of Manitoba, Dr. Gerald Niznick College of Dentistry

Lead Author

Mariana Perotta PhD Perotta

PhD

School of Dentistry, Tuiuti University of Paraná,

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Orofacial Pain