An association between vitamin D deficiency and many oral diseases, including caries periodontitis, tooth loss and osteonecrosis of the jaw, is known. However, it is rare to discover genetic vitamin D deficiency in adult from dental problem. Herein, we present the case of a 47-year-old female patient who visited dental department because of abscess on the right lower area. In medical history taking, the patient denied any systemic diseases, but she had bone fracture of legs many times since teenage. Thus, except for dental treatment, she was referred to orthopedic surgeon DEL for further management. Genetic vitamin D deficiency was diagnosed by endocrinologist through laboratory tests. Additionally, extraction of right mandibular first molar and sequestrectomy were performed due to bone lesion progression. There was slow and little bone repair in this socket. Fortunately, the dental condition is stable under regular dental follow-up and vitamin D supplementation. Thus, vitamin D deficiency would be included in differential diagnosis of bone lesion.
維生素D缺乏和許多口腔疾病包括蛀牙、牙周炎和牙齒脫落與顎骨壞死之間的關聯是眾所周知的。然而成人病患很少因為牙科疾病而被發現遺傳性維生素D缺乏症。本文報告一個47歲的女病人,她因為右下膿腫而到牙科求診。在過去病史的問診中,病人否認有任何全身性疾病,但她談到從十幾歲起至今,已經發生許多次的腿骨骨折。因此除了牙科治療,我們將病患轉介給骨科做進一步的診療處理。最終,新陳代謝科醫師通過檢驗,診斷為遺傳維生素D缺乏症。不幸的是,由於右下骨病變惡化,所以拔除第一大臼齒並同時進行齒槽骨清創手術。術後的骨修復雖然非常緩慢,但是在定期牙科追蹤和維生素D補充下,狀況維持穩定。因此,儘早發現維生素D缺乏症,以早期進行藥物治療,對牙科醫師非常重要。
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