Periodontal disease related to hypothyroidism

Abstract

It is mandatory to mention that more than 95% of the global population is presenting signs of periodontal disease (PD). The most common etiophatogenetic factor for PD is dental calculus and plaque. This main factor however is not the only feature which affect and aggravate the disease process, hormonal impairment are a frequent etiological factor for PD. This paper will present a clinical case of a 32 year old woman with a severe form of periodontal disease. The patient received a complex treatment paraclinical examination. With standard examination of PD patients (OPG, full mouth periodontal probing), the patient was examined by a general practioner and a endocrinologist, which revealed hypothyroidism in a low form that was treated 3 years ago. General blood analysis was performed and chemical analysis of blood for alkaline phosphatase. Local treatment with BioR 0.5% sol. for 5 days and general treatment with metronidazole 0.5 for 8 days in combination with doxacicline 0.25 for 8 days were administered prior to endodontic and prosthetic treatment. As stated by the endocrinologist the patient was examined 3 years ago for hypothyroidism in a medium form for 3 months, and no present signs of it are present. The patient related that prior to that treatment she was examined by a stomatologist which related to her that she had PD in a mild form so scaling was performed in a usual manner. Alkaline phosphatase shows no significant variations and general blood analysis too. Tooth mobility of II nd degree was related in a 56% of all present teeth, III rd degree in 20%. 4 teeth were extracted as they were out of the treatment plan. Following scaling, general and local treatment, endodontic treatment presented a significant tooth stability also stated by the patient. Prosthetic treatment showed a high level of esthetic rehabilitation and a future stability for the rest of the teeth. Hypothyroidism and other hormonal disease are considered lately as a major factor for periodontal disease it is fact stated by many articles, and comparative studies presented it’s reability. The present work is another one that supports this idea. Patients with PD especially the ones that present severe form of it need to be examined in a complex form because most of them present general disease and especially hormonal impairments. The metabolism of Calcium in the tissue is a major factor that may induce the periodontal disease; its mechanism is “washing” it away from blood and eliminates it thru natural fluid including saliva eventually it will be deposited on dental plaque and form the calculus.