The Lamina Dura

The lamina dura is the bony lining of the socket (alveolus) of a tooth. The periodontal ligaments extend from the lamina dura to the cementum of the tooth, an keep the tooth in place. The lamina dura is cribriform plate produced by the periodontal ligament and fibers of the periodontal ligament are embedded within it.

While loss of the lamina dura (arrow in image above) is sometimes said to be pathognomonic for hyperparathyroidism, it can be seen in a wide range of conditions:

• Hyperparathyroidism: The case above is from a patient with primary hyperparathyroidism.
• Osteomalacia
• Osteoporosis
• Paget disease
• Leukemia
• Myelomatosis
• Cushing disease

The lamina dura can be thickened in bisphosphonate-related osteonecrosis of jaw (BRONJ)

References

• Arce K, Assael LA, Weissman JL, Markiewicz MR. Imaging findings in bisphosphonate-related osteonecrosis of jaws. J Oral Maxillofac Surg. 2009 May;67(5 Suppl):75-84.
• Berry HM Jr. The lore and the lure o' the lamina dura. Radiology. 1973 Dec;109(3):525-8.

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