Characterization of Oral Health Status in Chilean Patients with X-Linked Hypophosphatemia

Calcif Tissue Int. 2021 Aug;109(2):132-138. doi: 10.1007/s00223-021-00841-4. Epub 2021 Apr 10.

Abstract

X-Linked Hypophosphatemia (XLH) is the most common cause of inherited hypophosphatemic rickets. Dental involvement, including spontaneous abscesses and/or fistulae, is an important part of the disease and has not been completely defined, especially in cohorts from developing countries. To describe oral health status in a cohort of Chilean patients with XLH and explore its correlation with biochemical presentation and treatment, we conducted a cross-sectional observational study of patients with PHEX mutation-confirmed XLH. All patients had an oral clinical exam, radiographic evaluation; clinical and biochemical data were obtained to determine their association with oral features. Twenty-six patients were included, 77% adults and 23% children. Most adults (89%) had past or current dental pulp pathology (abscesses and/or fistulae). Pulpal chamber enlargement and radiolucent apical lesions were common radiological features (94 and 74%, respectively). In children, abscess and/or fistulae were also common (33%). Caries index, which was determined by dmft/DMFT, was higher than the Chilean national average. Early and long-term therapy with phosphate and activated vitamin D was associated with lower carious index and attachment loss. XLH patients frequently present with high pulpal involvement and carious index. Conventional therapy was associated with lower carious index and attachment loss. These data highlight the importance of early and periodical dental care in order to prevent dental damage and assure a good quality of oral health for XLH patients.

Keywords: FGF23; Hypophosphatemic rickets; Spontaneous abscess; Spontaneous fistulae; X-linked hypophosphatemia.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Cross-Sectional Studies
  • Familial Hypophosphatemic Rickets* / complications
  • Familial Hypophosphatemic Rickets* / epidemiology
  • Familial Hypophosphatemic Rickets* / genetics
  • Fibroblast Growth Factor-23
  • Humans
  • Hypophosphatemia*
  • Mutation
  • Oral Health
  • PHEX Phosphate Regulating Neutral Endopeptidase / genetics
  • Phosphates

Substances

  • FGF23 protein, human
  • Phosphates
  • Fibroblast Growth Factor-23
  • PHEX Phosphate Regulating Neutral Endopeptidase