Pseudohypoparathyroidism diagnosed in adulthood: maxillofacial clinical and radiographic findings

Pseudohypoparathyroidism is a rare condition first described in 1942. Affected patients do not have a deficiency of parathyroid hormone; instead, the kidneys and bones are unable to respond to parathyroid hormone in the normal manner. Few cases of pseudohypoparathyroidism have been reported in the dental literature, and most do not describe the advanced condition because the diagnosis is usually made, and treatment commenced, at an early age. We herein describe a patient who was diagnosed with pseudohypoparathyroidism at the age of 28 years, after completion of full facial and skeletal development. Panoramic radiography revealed a large number of impactions and incomplete root formation. Cone beam computed tomography (CBCT) showed calcification of the basal ganglia of the brain and incomplete root formation of the teeth with thin enamel and large pulp chambers. To our knowledge, this is the first patient with pseudohypoparathyroidism to be studied with both panoramic radiography and CBCT. Pseudohypoparathyroidism is a rare condition that has not been previously studied with CBCT. The characteristic clinical and radiographic findings should alert dentists to this condition.