Avaliação do processo estilóide do osso temporal e ocorrência de placas ateromatosas calcificadas em radiografias panorâmicas de indivíduos com hiperparatireoidismo primário e hipoparatireoidismo pós-cirúrgico

Abstract

Primary hyperparathyroidism (PHPT) and postoperative hypoparathyroidism (hypoPT) are characterized by altered serum levels of parathyroid hormone (PTH), which plays an important role in tooth development and bone mineralization. The mineralization pattern of the temporal bone styloid process (TBSP) and the prevalence of calcified atheromatous plaques (CAP) may be influenced by endocrine changes that regulate the osteometabolic balance. The present investigation aimed to evaluate PHPT aspects (length and mineralization patterns) and the occurrence of suggestive images of CAP among patients with PHPT and

postoperative hypoPT compared to controls on panoramic radiographs. This is a cross- sectional case-control study with patients diagnosed with PHPT (n=25) and post-surgical

hypoPT (n=25), from the Endocrinology and Diabetology Service of the Walter Cantídio University Hospital (Fortaleza-CE) in addition to individuals without disorders in the parathyroid glands for the control group (n=50) Panoramic radiographs of individuals who met the eligibility criteria of the present study were used to carry out the quantitative (length) and qualitative (mineralization patterns) assessment of the TBSP, as well as the assessment of the prevalence of CAP. The Data was tabulated in Microsoft Excel®

and exported to the

Statistical Package for the Social Sciences (SPSS®

) Software, version 20.0 for Windows® , in which the analyses were performed adopting a 95% confidence interval. Parametric data comparing two independent groups were analyzed using the t-test (Student), while comparisons involving more than two independent groups used analysis of variance (ANOVA/Bonferroni). Non-parametric data were expressed as absolute and percentage frequencies and compared using the chi-square or Fisher's exact tests. In addition, a multivariate analysis adjusted for confounding factors that could influence the results between groups regarding the mean PEOT length was performed. The frequency of TBSP above 30mm, both on the right (p=0.002), left (p=0.003), and mean sides (p=0.007) was higher in the PHPT or post-surgical hypoPT groups compared to the control group. Atheromatous plaques occurred statistically significantly (p=0.011) in the PHPT group (24%) compared to the postsurgical hypoPT (16%) and control (2%) groups, with low bone mineral density (BMD) being frequent in these cases associated to PHPT. Low BMD in the PHPT group was associated with both greater mean TBSP length (p=0.025) and increased frequency of elongated TBSP (p=0.022). Multivariate analysis showed in the PHPT group an inversely proportional relationship between the femoral neck T-score and the TBSP length (p=0.028). In summary, individuals with post-surgical PHPT and hypoPT present imaging findings related to TBSP and the occurrence of CAP that differed when compared to the control group. Individuals with PHPT and low BMD exhibited a higher frequency of elongated TBSP.