Hyperthyroidism: Report of a case exhibiting periapical changes

Abstract

The generalized accelerated metabolic rate found in hyperthyroidism is characterized by well-known skeletal changes that have been reported in the medical literature. A perusal of the pertinent references and published papers does not specifically describe osseous changes of the mandible or maxilla due to hyperthyroidism. A case of hyperthyroidism (Graves' disease) that exhibited periapical rarefactions which filled in completely upon surgical treatment is presented. An interesting feature of this case is that the radiographic record, intact over a sixteen-year period, disclosed the first evidence of periapical rarefaction more than two years before the clinical subjective symptoms of hyperthyroidism sent the patient to her physician. It is not to be construed that henceforth periapical rarefactions should be considered pathognomonic of generalized metabolic disease. However, this case emphasizes once again that not all apical radiolucencies are of pulpal origin.