Panoramic radiographs of 18 patients with end stage renal disease with concomitant secondary hyperparathyroidism and those of 18 age- and sex-matched healthy subjects were evaluated using the scoring system of Kelly et al (13), as well as a quantitative morphometric method with special emphasis on the bone density, trabecular pattern, and the extent of the compact bone. No correlation could be established between the serum values of Ca, Pi, Afos, and parathormone on one hand, and the radiographic parametres on the other, with either of the two systems used. Morphometrically measured volume densities (Vi) of the trabecular (VT), and the medullary space (VM) in the diseased and in healthy persons significantly differed from each other (P<0.001). The volume density of the compact bone (VC) was equal in both series. The nonquantitative grading system used did not reveal any differences between the two series studied. The results suggests that the mandible seems to be affected by the secondary hyperparathyroidism associated with end stage renal disease. The direct morphometric method introduced here seems to provide a new applicable tool in assessing the radiographic changes due to metabolic bone disorders.
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Syrjänen et al. (1983) studied this question.