Macrognathia Secondary to Renal Osteodystrophy in a Hemodialysis Patient: A Case Report and Literature Review
4 affiliations
- 1Clinical Dental Sciences Department, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- 2Center for Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- 3Basic Medical and Dental Sciences Department, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- 4Biomedical Sciences Department, College of Medicine, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates
Abstract
Background: Renal osteodystrophy (ROD) is a complex metabolic bone disorder encompassing the full spectrum of skeletal abnormalities arising from chronic kidney disease–mineral and bone disorder (CKD-MBD). Although ROD is a well-recognized systemic complication of end-stage renal disease (ESRD), its manifestation as progressive maxillofacial enlargement macrognathia is rare and may precede recognition of the underlying nephropathy in clinical dental settings. The paper aims to report a case of ROD-associated macrognathia in a patient on long-term hemodialysis and a contemporary literature review. Case Presentation: We describe a 45-year-old female patient on long-term maintenance hemodialysis for ESRD secondary to Grade I bilateral nephropathy who presented to our dental clinic with a 6-month history of progressive, painless diffuse swelling of the mandibular anterior region that subsequently involved the hard palate. Oral examination revealed bilateral jaw enlargement, severe generalised periodontitis, xerostomia, uremic fetor, and hyposalivation. Panoramic radiography demonstrated ground-glass trabecular changes, cortical thinning, and loss of the inferior cortex. Histopathology of an incisional biopsy revealed features of fibrous replacement of medullary bone, irregular osteoid mineralization, increased osteoblastic activity, and osteoclastic resorption lacunae suggestive of osteitis fibrosa cystica. Conclusions: This case illustrates the importance of the dental clinician’s role in recognizing the oral and maxillofacial manifestations of systemic metabolic disease. Macrognathia should be included in the differential diagnosis of jaw enlargement in any patient with a history of CKD or ESRD. Multidisciplinary collaboration between dentists, oral pathologists, and nephrologists is essential for timely diagnosis and optimal management.
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BibTeX
@article{jaber2026macrognathia,
title = {{Macrognathia Secondary to Renal Osteodystrophy in a Hemodialysis Patient: A Case Report and Literature Review}},
author = {Mohamed Jaber and Mohamed S. Ingagou and Abdullah M. Elameen and Prathibha Prasad and Mehzabin Ahmed},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218256},
url = {https://www.mdpi.com/2077-0383/15/21/8256},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Macrognathia Secondary to Renal Osteodystrophy in a Hemodialysis Patient: A Case Report and Literature Review
AU - Mohamed Jaber
AU - Mohamed S. Ingagou
AU - Abdullah M. Elameen
AU - Prathibha Prasad
AU - Mehzabin Ahmed
PY - 2026
DA - 2026/10/23
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218256
UR - https://www.mdpi.com/2077-0383/15/21/8256
AB - Background: Renal osteodystrophy (ROD) is a complex metabolic bone disorder encompassing the full spectrum of skeletal abnormalities arising from chronic kidney disease–mineral and bone disorder (CKD-MBD). Although ROD is a well-recognized systemic complication of end-stage renal disease (ESRD), its manifestation as progressive maxillofacial enlargement macrognathia is rare and may precede recognition of the underlying nephropathy in clinical dental settings. The paper aims to report a case of ROD-associated macrognathia in a patient on long-term hemodialysis and a contemporary literature review. Case Presentation: We describe a 45-year-old female patient on long-term maintenance hemodialysis for ESRD secondary to Grade I bilateral nephropathy who presented to our dental clinic with a 6-month history of progressive, painless diffuse swelling of the mandibular anterior region that subsequently involved the hard palate. Oral examination revealed bilateral jaw enlargement, severe generalised periodontitis, xerostomia, uremic fetor, and hyposalivation. Panoramic radiography demonstrated ground-glass trabecular changes, cortical thinning, and loss of the inferior cortex. Histopathology of an incisional biopsy revealed features of fibrous replacement of medullary bone, irregular osteoid mineralization, increased osteoblastic activity, and osteoclastic resorption lacunae suggestive of osteitis fibrosa cystica. Conclusions: This case illustrates the importance of the dental clinician’s role in recognizing the oral and maxillofacial manifestations of systemic metabolic disease. Macrognathia should be included in the differential diagnosis of jaw enlargement in any patient with a history of CKD or ESRD. Multidisciplinary collaboration between dentists, oral pathologists, and nephrologists is essential for timely diagnosis and optimal management.
SN - 2077-0383
ER -