Hyperparathyroidism Jaw Signs — ORE Part 1 MCQ
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Correct answer: D — Generalised loss of the dental lamina dura
The best answer is D. Generalised loss of the lamina dura is the classic dental radiographic sign of hyperparathyroidism, reflecting increased bone resorption associated with excess parathyroid hormone. Brown tumours may occur in severe disease, but are uncommon and should not be combined with lamina-dura loss in a single option. A ground-glass pattern can be described with metabolic bone change, but is not as characteristic or specific as loss of lamina dura. Cotton-wool sclerosis suggests Paget disease, whereas sunray spiculation suggests an aggressive bone-forming malignancy such as osteosarcoma. A floating-tooth appearance is more classically associated with Langerhans cell histiocytosis or severe alveolar bone destruction, not uncomplicated primary hyperparathyroidism.
Reference: Heggie AA, Kumar R, et al. Systematic review of oral manifestations related to hyperparathyroidism. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2017. https://pubmed.ncbi.nlm.nih.gov/40539180/