Paget's Disease of Bone

[Virtual Presenter] Welcome to our presentation on Paget’s Disease of Bone. This condition, also known as osteitis deformans, has been studied extensively since its discovery over 130 years ago. We will explore its historical significance, effects on individuals, and implications for dental hygiene treatment. Let’s begin our journey into understanding this fascinating topic..

[Audio] Paget's disease is a chronic bone disorder that affects the way our bodies remove and replace old bone tissue. This process, called bone remodeling, normally happens throughout our lives, but in Paget's disease, it becomes abnormal. As a result, the bones become enlarged, deformed, and weakened. This can lead to a range of symptoms, including bone pain, deformity, and increased risk of fractures..

[Audio] The body constantly removes old bone and adds new bone to the skeleton throughout our lifetime. As we age, this process happens at a slower pace. When Paget's disease starts, the body loses much more bone than it makes. As the disease progresses, new bone forms at a faster rate than the rate at which old bone is removed. However, the new bone does not form correctly, leading to larger bones that are misshapen, weaker, and softer than normal bone. Doctors do not know the exact cause of Paget's disease, but research suggests that environmental factors and genes may play a role in its development. Scientists have identified changes in genes that may increase the chance of developing the disease, and researchers are studying how certain viruses may cause the disease in people who already have risk factors..

[Audio] Paget's disease of bone, also known as osteitis deformans, was first described by Sir James Paget over 130 years ago. The disease is a common focal skeletal disorder that can affect a single bone or multiple bones. While many patients are asymptomatic, others experience significant symptoms such as bone pain, bone deformity, secondary arthritis, and neurologic problems. Treatment options, including calcitonin and newer bisphosphonates, have been developed over the years to manage the disease. Historically, cases of the disease were often confused with other conditions, but Sir James Paget's work helped establish the disease as a distinct entity worthy of its own place in pathology..

[Audio] Many people with Paget's disease of bone do not experience any symptoms. However, if symptoms appear, they can include bone or joint pain, skin feeling warm over the affected bone, changes in bone shape, a shooting pain that travels along or across the body, numbness and tingling, or balance problems. The condition can affect any bone, but typically occurs in the spine, pelvis, femur and tibia, and skull. In advanced cases, people may experience misshapen bones and other bone changes, such as increased head size, bow-shaped limbs, or curvature of the spine. Depending on the bone affected, additional symptoms can develop, including headaches and hearing loss if the skull is involved, tingling and numbness in the arms and legs if the spine is affected, or hip pain if the pelvis or thigh bone is involved..

[Audio] Treatment options for Paget's disease include medications, surgery, exercise, and dietary measures. The primary medications prescribed are bisphosphonates, which control excessive bone breakdown and formation, and calcitonin, which regulates blood calcium and phosphate levels and promotes new bone formation. Surgery may be necessary to correct complications such as fractures, arthritis, or misshapen bones. Exercise and a balanced diet rich in calcium and vitamin D can help maintain strong bones and prevent complications..

[Audio] The patient, who was a tall, thin, well-formed man, remained healthy until the age of 46, when he started experiencing aching pains in his thighs and legs, particularly after physical activity. Despite these symptoms, his overall health remained unaffected. Over time, his limbs became less agile, and his left shin began to show signs of deformation. A second patient, a master of hounds, experienced similar symptoms, including curvature of the thighs and legs, and eventually, a broken humerus due to a tumor. Both patients showed no signs of disease before the onset of their symptoms, and their general health remained unaffected throughout the progression of the disease..

[Audio] The effects of Paget's disease on dental hygiene treatment are substantial. When the disease affects the jaw, it can lead to significant complications, such as tooth loss, malocclusion, and improper fit of dentures. Additionally, there is an increased risk of root resorption, increased cementum, and excessive bleeding during extractions. Furthermore, osteomyelitis can occur due to the disease. These complications highlight the importance of proper diagnosis and treatment of Paget's disease to prevent these oral health issues..