Journals / Selcuk Dental Journal / 2026 / Volume: 13 Issue: 2

Oral and Radiographic Findings of Vitamin D Deficiency–Related Secondary Hyperparathyroidism: Two Case Reports

Selinay Sarı Kurt(KÜTAHYA SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ, KLİNİK BİLİMLER BÖLÜMÜ, AĞIZ, DİŞ VE ÇENE RADYOLOJİSİ ANABİLİM DALI)0009-0000-1492-8430
Melike Yurttaş(KÜTAHYA SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ, KLİNİK BİLİMLER BÖLÜMÜ, AĞIZ, DİŞ VE ÇENE RADYOLOJİSİ ANABİLİM DALI)0000-0002-3311-1642
Halil Ayyıldız(KÜTAHYA SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ, KLİNİK BİLİMLER BÖLÜMÜ, AĞIZ, DİŞ VE ÇENE RADYOLOJİSİ ANABİLİM DALI)0000-0001-8633-1764
Pages
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Publication Date
2026-08-24
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Key Words: Parathyroid hormone, dentistry, vitamin D

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background: Vitamin D plays a central role in physiological functions by regulating calcium and phosphate metabolism, promoting growth, and facilitating the remodeling of bones and teeth.
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Key Findings & Data:Radiographic examination of Case 1 revealed generalized root resorption, localized loss of the lamina dura, and slight thickening of the inferior cortical layer of the mandible.
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Conclusion & Impact:Key Words: Parathyroid hormone, dentistry, vitamin D
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Parathyroid hormone · dentistry · vitamin D

Abstract

Background: Vitamin D plays a central role in physiological functions by regulating calcium and phosphate metabolism, promoting growth, and facilitating the remodeling of bones and teeth. Vitamin D deficiency (VDD) can result in hypocalcemia and the development of secondary hyperparathyroidism (SHPT), which may manifest with multiple oral and maxillofacial symptoms, including jaw expansion, loss of the lamina dura, root resorption, pulp obliteration, and alterations in bone density. Case: This case report presents the oral and radiographic findings of two male patients who developed SHPT due to VDD. Radiographic examination of Case 1 revealed generalized root resorption, localized loss of the lamina dura, and slight thickening of the inferior cortical layer of the mandible. In Case 2, intraoral examination demonstrated generalized alveolar ridge expansion in both jaws, pronounced diastemas between teeth, and localized loss of the lamina dura. Both patients exhibited a “ground-glass” appearance of the jawbones. Discussion: The clinical and radiographic findings in these cases are consistent with the characteristic oral features of VDD-related SHPT, including reduced bone mineralization, loss of the lamina dura and ground-glass trabeculation. Less common findings like root resorption and alveolar ridge expansion may indicate more advanced metabolic disturbance. Conclusions: These cases emphasize the importance of recognizing oral and radiographic indicators of VDD-related SHPT, enabling timely diagnosis and appropriate interdisciplinary management. Key Words: Parathyroid hormone, dentistry, vitamin D

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Cite This Article

Kurt, S. S., Yurttaş, M., Ayyıldız, H., *, S. S. K. (2026). Oral and Radiographic Findings of Vitamin D Deficiency–Related Secondary Hyperparathyroidism: Two Case Reports. Selcuk Dental Journal, Volume: 13 Issue: 2. https://doi.org/10.15311/selcukdentj.1847522

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References (46)

  1. Khundmiri SJ, Murray RD, Lederer E. PTH and Vitamin D. Compr Physiol. 2016;6(2):561-601, https://doi.org/10.1002/cphy.c140071
  2. Aggarwal P, Zavras A. Parathyroid hormone and its effects on dental tissues. Oral Dis. 2012;18(1):48-54, https://doi.org/10.1111/j.1601-0825.2011.01850.x
  3. Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients. 2020;12(5), https://doi.org/10.3390/nu12051471
  4. Binkley N, Ramamurthy R, Krueger D. Low vitamin D status: definition, prevalence, consequences, and correction. Endocrinol Metab Clin North Am. 2010;39(2):287-301, table of contents, https://doi.org/10.1016/j.ecl.2010.02.008
  5. Uwitonze AM, Murererehe J, Ineza MC, Harelimana EI, Nsabimana U, Uwambaye P, et al. Effects of vitamin D status on oral health. J Steroid Biochem Mol Biol. 2018; 175:190-4, https://doi.org/10.1016/j.jsbmb.2017.01.020
  6. Mellouli N, Belkacem Chebil R, Darej M, Hasni Y, Oualha L, Douki N. Mandibular Osteitis Fibrosa Cystica as First Sign of Vitamin D Deficiency. Case Rep Dent. 2018; 2018:6814803, https://doi.org/10.1155/2018/6814803
  7. Cunningham J, Locatelli F, Rodriguez M. Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options. Clin J Am Soc Nephrol. 2011;6(4):913-21.
  8. Albalooshy A. Vitamin D deficiency and chronological hypoplasia with hypomineralisation: a case report. J Clin Pediatr Dent. 2024;48(3):177-81, https://doi.org/10.2215/cjn.06040710
  9. Mittal S, Gupta D, Sekhri S, Goyal S. Oral manifestations of parathyroid disorders and its dental management. J Dent Allied Sci. 2014;3(1):34-8, https://doi.org/10.4103/2277-4696.156527
  10. Grimm M, Cetindis M, Biegner T, Lehman M, Munz A, Teriete P, et al. Serum vitamin D levels of patients with oral squamous cell carcinoma (OSCC) and expression of vitamin D receptor in oral precancerous lesions and OSCC. Med Oral Patol Oral Cir Bucal. 2015;20(2):e188-95, https://doi.org/10.4317/medoral.20368
  11. Osafi J, Hejazi A, Stutz DD, Keiserman MA, Bergman CJ, Kingsley K. Differential effects of 1, 25-dihydroxyvitamin D3 on oral squamous cell carcinomas in vitro. Journal of Dietary Supplements. 2014;11(2):145-54, https://doi.org/10.3109/19390211.2013.859209
  12. Scardina G, Messina P. Good oral health and diet. BioMed Research International. 2012;2012(1):720692, https://doi.org/10.1155/2012/720692
  13. Deng Y, Sun Y, Xu T. Evaluation of root resorption after comprehensive orthodontic treatment using cone beam computed tomography (CBCT): a meta-analysis. BMC Oral Health. 2018;18(1):116. Published 2018 Jun 27. doi:10.1186/s12903-018-0579-2
  14. Alshomrani F. Cone-Beam Computed Tomography (CBCT)-Based Diagnosis of Dental Bone Defects. Diagnostics (Basel). 2024;14(13):1404. Published 2024 Jul 1. doi:10.3390/diagnostics14131404
  15. Sumer T, Sumer AP, Zengin AZ, Muglali M, Abaci SH. Comparison of Imaging Features of Intraosseous Jaw Lesions on Panoramic Radiographs and Cone Beam Computed Tomography. J Craniofac Surg. Published online February 9, 2026. doi:10.1097/SCS.0000000000012531
  16. Patel A, Chava S, Jawahar A, et al. Retrospective Study of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: Clinical, Radiological, and Pathological Diagnosis. J Pharm Bioallied Sci. 2026;18(Suppl 1): S156-S158. doi: 10.4103/jpbs.jpbs_1602_25
  17. Mainville GN, Turgeon DP, Kauzman A. Diagnosis and management of benign fibro-osseous lesions of the jaws: a current review for the dental clinician. Oral Dis. 2017;23(4):440-450. doi:10.1111/odi.12531
  18. Burke AB, Collins MT, Boyce AM. Fibrous dysplasia of bone: craniofacial and dental implications. Oral Dis. 2017;23(6):697-708. doi:10.1111/odi.12563
  19. J P, Nisha V A, Gs A, Ca P, Mm V. Oral manifestations in a renal osteodystrophy patient - a case report with review of literature. J Clin Diagn Res. 2014;8(8):ZD28-ZD30. doi:10.7860/JCDR/2014/8879.4722
  20. You M, Tang B, Wang ZJ, Wang KL, Wang H. Radiological manifestations of renal osteodystrophy in the orofacial region: a case report and literature review. Oral Radiol. 2018;34(3):262-266. doi:10.1007/s11282-017-0291-y
  21. Amaya N, Itoiz ME, Paparella ML. Paget's disease of the jaws: Histopathological features of a series of 31 cases. Enfermedad de Paget en los maxilares. Características histopatológicas de una serie de 31 casos. Acta Odontol Latinoam. 2021;34(3):257-262. doi:10.54589/aol.34/3/257
  22. White SC, Pharoah MJ. Oral Radiology - E-Book: Principles and Interpretation: Elsevier Health Sciences; 2014. 697 p.
  23. Jagelavičienė E, Vaitkevičienė I, Šilingaitė D, Šinkūnaitė E, Daugėlaitė G. The Relationship between Vitamin D and Periodontal Pathology. Medicina (Kaunas). 2018;54(3), https://doi.org/10.3390/medicina54030045
  24. Al-Quisi AF, F AJ, A MA-A, Jassim Muhsen S. Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study. ScientificWorldJournal. 2024; 2024:9933646, https://doi.org/10.1155/2024/9933646
  25. Alpdemir M, Alpdemir MF. Vitamin D deficiency status in Turkey: A meta-analysis. Int J Med Biochem. 2019;2(3):118-31.
  26. Oskovi Kaplan ZA, Taşçi Y, Topçu HO, Erkaya S. 25-Hydroxy vitamin D levels in premenopausal Turkish women with uterine leiomyoma. Gynecol Endocrinol. 2018;34(3):261-4, https://doi.org/10.1080/09513590.2017.1391774
  27. Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, et al. IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab. 2012;97(4):1146-52, https://doi.org/10.1210/jc.2011-2218
  28. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30, https://doi.org/10.1210/jc.2011-0385
  29. Cheng X, Chen L, Zang H, Li Y. The clinical application of mitoxantrone hydrochloride tracing in endoscopic radical resection of thyroid carcinoma. Sci Rep. 2025;15(1):23352, https://doi.org/10.1038/s41598-025-07289-8
  30. Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014;111(1):23-45, https://doi.org/10.1017/s0007114513001840
  31. Verma P, Verma KG, Verma D, Patwardhan N. Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity. J Oral Maxillofac Pathol. 2014;18(2):267-270. doi:10.4103/0973-029X.140779
  32. Gadhia T, Adegun OK, Fortune F. Brown tumours: widespread involvement of multiple maxillofacial bones and cervical spine. BMJ Case Rep. 2014 Nov 14;2014: bcr2014207140.
  33. Kakade SP, Gogri AA, Umarji HR, Kadam SG. Oral manifestations of secondary hyperparathyroidism: A case report. Contemp Clin Dent. 2015;6(4):552-8, https://doi.org/10.4103/0976-237x.169840
  34. Guimarães LM, Valeriano AT, Rebelo Pontes HA, Gomez RS, Gomes CC. Manifestations of hyperparathyroidism in the jaws: Concepts, mechanisms, and clinical aspects. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022;133(5):547-55, https://doi.org/10.1016/j.oooo.2021.08.020
  35. Palla B, Burian E, Fliefel R, Otto S. Systematic review of oral manifestations related to hyperparathyroidism. Clin Oral Investig. 2018;22(1):1-27, https://doi.org/10.1007/s00784-017-2124-0
  36. Sugiura T, Yamamoto K, Kawakami M, Horita S, Murakami K, Kirita T. Influence of bone parameters on peri-implant bone strain distribution in the posterior mandible. Med Oral Patol Oral Cir Bucal. 2015;20(1):e66-73, https://doi.org/10.4317/medoral.19878
  37. Khamees AM, Al Groosh DH, Al-Rawi NH. Effects of vitamin D deficiency on bone and root resorption post-orthodontic retention in rats. Journal of Baghdad College of Dentistry. 2023;35(2):54-64, https://doi.org/10.26477/jbcd.v35i2.3403
  38. D'Ortenzio L, Ribot I, Kahlon B, Bertrand B, Bocaege E, Raguin E, et al. The rachitic tooth: The use of radiographs as a screening technique. Int J Paleopathol. 2018; 23:32-42, https://doi.org/10.1016/j.ijpp.2017.10.001
  39. Ge X, Li Z, Jing S, Wang Y, Li N, Lu J, et al. Parathyroid hormone enhances the osteo/odontogenic differentiation of dental pulp stem cells via ERK and P38 MAPK pathways. J Cell Physiol. 2020;235(2):1209-21, https://doi.org/10.1002/jcp.29034
  40. Gürhan C, Saruhan E. Pulp stones: any relevance with the levels of serum calcium, parathyroid hormone, vitamin D and uric acid. Restor Dent Endod. 2024;49(2):e17. Published 2024 Mar 26. doi:10.5395/rde.2024.49.e17
  41. Barra SG, Gomes IP, Amaral TMP, Brasileiro CB, Abreu LG, Mesquita RA. New mandibular indices in cone beam computed tomography to identify low bone mineral density in postmenopausal women. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131(3):347-55, https://doi.org/10.1016/j.oooo.2020.07.016
  42. Zihni Korkmaz M, Yemenoğlu H, Günaçar DN, Ustaoğlu G, Ateş Yildirim E. The effects of vitamin D deficiency on mandibular bone structure: a retrospective radiological study. Oral Radiol. 2023;39(1):67-74, https://doi.org/10.1007/s11282-022-00602-5
  43. postmenopausal women. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131(3):347-55, https://doi.org/10.1016/j.oooo.2020.07.016
  44. Zihni Korkmaz M, Yemenoğlu H, Günaçar DN, Ustaoğlu G, Ateş Yildirim E. The effects of vitamin D deficiency on mandibular bone structure: a retrospective radiological study. Oral Radiol. 2023;39(1):67-74, https://doi.org/10.1007/s11282-022-00602-5
  45. Aerden T, Grisar K, Nys M, Politis C. Secondary hyperparathyroidism causing increased jaw bone density and mandibular pain: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(3):e37-e41, https://doi.org/10.1016/j.oooo.2017.11.020
  46. Wang C, Fu R, Yang H. Toward a clear relationship between mechanical signals and bone adaptation. Mechanobiol Med. 2025;3(1):100115, https://doi.org/10.1016/j.mbm.2025.100115