Paget's Disease Of The Jaws: A Contemporary Reappraisal

Abstract

Paget’s disease is a chronic, slowly progressive metabolic disorder of bone. Paget’s disease of the head and neck primarily affects the skull and facial bones; the jaws are infrequently involved. An elderly patient is commonly affected. Radiographically, it shows a typical cotton wool appearance and is accompanied by raised serum alkaline phosphatase or urinary hydroxyproline. The histopathological features of Paget’s disease resemble fibro-osseous lesions like florid cemento-osseous dysplasia and sequestrum of non-healing sockets. Osteoarthritis, osteosarcoma, and giant cell tumors are complications of Paget’s disease. Hypercalcemia can occur in patients with Paget's disease who are immobilized, and high-output cardiac failure can arise as a complication of active disease. Despite there being very limited published literature on the Indian population, it is both underdiagnosed and undertreated, with many patients never coming to medical attention. This review focused on an overview of Paget's disease and the mechanisms underlying expansile osteolysis and associated conditions of the jaws.