Paget's disease in the maxilla, mandible, and palate: A histologic analysis

Abstract

Microscopic study of the maxilla, mandible, and palate in Paget's disease revealed the following features: Bone formation, resorption, degeneration, and inactivity heterogeneously distributed in close proximity to each other. Alteration of the previously existing bone pattern and its replacement by a honeycomb of newly formed bone trabeculae. Replacement of fatty marrow by vascular connective tissue in accordance with no regular pattern. Pronounced bone formation associated with connective tissue marrow and absence of formation, associated with fatty marrow. Pronounced osteoclastic activity, and degeneration in zones of bone formation. Scattered areas in which the bone presents a mosaic pattern as the result of recurrent opposition and resorption. Isolated foci of bone degeneration and increased calcification. The changes observed in the maxilla, mandible, and palate were similar to those described in the remainder of the skeletal system in Paget's disease. A comparison of the findings in Paget's disease with those observed in the mandible and maxilla in non-Paget individuals of a similar age group revealed that all of the individual histologic changes observed in Paget's disease could be duplicated in non-Paget individuals. Although Paget's disease is recognizable as a composite histologic entity, it represents an alteration in severity and pattern, but not in the basic nature of the detailed histologic changes which generally occur in the mandible and maxilla in non-Paget individuals.