Radiologically Identified Morphologic Changes of Maxillary and Mandibular Bones among Diagnosed Cases of Skeletal Fluorosis in Ethiopia

In 1937, the chronic toxic effect of fluoride on skeletal fluorosis was demonstrated for the first time in history in the Indian state of Madras. Exposure to fluoride concentrations greater than eight ppm in water is reported to cause skeletal fluorosis. Skeletal fluorosis is a chronic metabolic bone disease resulting from prolonged ingestion of large amounts of fluoride. Bone knee syndrome, osteosclerosis, pathological fractures, calcification of ligaments, joint stiffness, immobility, muscle atrophy, and severe forms of neurological deficits are some of the consequences of skeletal fluorosis. Skeletal fluorosis, as such, is a highly morbid disease. Yet, the condition is overlooked, and, most importantly, little is known about its effects on the facial skeleton. This unique, investigative, cross-sectional study was initiated to evaluate the morphologic changes in the jawbone caused by skeletal fluorosis in adults diagnosed with skeletal fluorosis. A two-dimensional radiograph was used to evaluate the possible skeletal fluorosis-related morphological changes in the maxillary and mandibular bones. A total of 9 patients diagnosed with skeletal fluorosis underwent panoramic radiography of the mandibular and maxillary bones. Several skeletal fluorosis-related morphological changes were detected in the jaw bones of 6 study participants, including exostosis, osteosclerosis, thickened cortical bone, narrowed bone marrow, and periosteal plaques. According to studies, these morphological changes pose a serious threat to the healing process of the bone. Therefore, surgeons practicing in the Oro-craniofacial region must be alert to potential perioperative and postoperative complications when treating patients diagnosed with skeletal fluorosis.