1
|
Liu F, Wang X, He Y, Han R, Wang T, Guo Y. Jaw osteoporosis: Challenges to oral health and emerging perspectives of treatment. Biomed Pharmacother 2024; 177:116995. [PMID: 38917761 DOI: 10.1016/j.biopha.2024.116995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
Osteoporosis is a prevalent bone metabolic disease that poses a significant challenge to global human health. Jaw osteoporosis, characterized by microstructural damage of the jaw resulting from various factors, is one of the common manifestations of this condition. Recent studies have demonstrated that jaw osteoporosis has multifaceted effects on oral health and can negatively impact conditions such as periodontitis, oral implantation, orthodontic treatment, and wound healing. However, there are still some limitations in the conventional treatment of osteoporosis. For instance, while bisphosphonates can enhance bone quality, they may also lead to osteonecrosis of the jaw, which poses a potential safety hazard in oral diagnosis and treatment. In recent years, considerable attention has been focused on improving the pathological condition of jaw osteoporosis. Treatment strategies such as gut microbial regulation, extracellular vesicles, molecular targeted therapy, herbal medicine, mechanical stimulation are expected to enhance efficacy and minimize adverse reactions. Therefore, understanding these effects and exploring novel treatments for jaw osteoporosis may provide new insights for oral health maintenance and disease treatment. This article reviews the impact of jaw osteoporosis on oral health and describes the limitations associated with current methods. It also discusses emerging perspectives on treatment, offering a comprehensive overview of the challenges and future directions in managing jaw osteoporosis.
Collapse
Affiliation(s)
- Fushuang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuan Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yikai He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ruiying Han
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tianyi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yongwen Guo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
| |
Collapse
|
2
|
Ozcan G, Sekerci AE, Gönen ZB. Are there any differences in mandibular morphology of patients with bisphosphonate-related osteonecrosis of jaws?: a case-control study. Dentomaxillofac Radiol 2016; 45:20160047l. [PMID: 27181052 PMCID: PMC5124773 DOI: 10.1259/dmfr.20160047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/01/2016] [Accepted: 05/11/2016] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES: The aim of this study was to compare the morphological differences in the mandible between patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ) and healthy individuals and to detect the correlation between these parameters on panoramic radiography and CBCT. METHODS: The CBCT and panoramic images of patients with BRONJ (n = 32) and control groups (n = 32) were included in the study. All the comparisons were analyzed between the osteonecrosed and healthy sides of patients with BRONJ and control group. The panoramic radiographs were used to measure the values of the condyle angle, gonial angle, antegonial angle, antegonial depth, condylar height and ramal height. The mandibular cortical index (MCI) and bone quality index (BQI) were also examined on cross-sectional scans of CBCT images. RESULTS: There were significant differences in the MCI (p = 0.014) and BQI (p = 0.021) between the left and right side of the BRONJ group and also between the osteonecrosed side of the BRONJ and control group (p < 0.0001). No significant difference was found in other comparisons. CONCLUSIONS: The outcomes of the present study indicate that bisphosphonates influenced some internal morphological changes in the mandible. These changes may be a reason of BRONJ. But, these changes are not reflective of the measured values obtained using panoramic radiographs on the external morphology of the mandible.
Collapse
Affiliation(s)
- Gozde Ozcan
- Department of Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ahmet E Sekerci
- Department of Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Zeynep B Gönen
- Department of Maxillofacial Surgery, Faculty of Dentistry, Genome and Stem Cell Center, Erciyes University, Kayseri, Turkey
| |
Collapse
|
3
|
ALONSO MBCC, VASCONCELOS TV, LOPES LJ, WATANABE PCA, FREITAS DQ. Validation of cone-beam computed tomography as a predictor of osteoporosis using the Klemetti classification. Braz Oral Res 2016; 30:S1806-83242016000100263. [DOI: 10.1590/1807-3107bor-2016.vol30.0073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/30/2016] [Indexed: 11/22/2022] Open
|
4
|
Morioka T, Matsunaga S, Yoshinari M, Ide Y, Nakano T, Sekine H, Yajima Y. Alignment of Biological Apatite Crystallites at First Molar in Human Mandible Cortical Bone. Cranio 2014; 30:32-40. [DOI: 10.1179/crn.2012.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
5
|
Tozoğlu U, Cakur B. Evaluation of the morphological changes in the mandible for dentate and totally edentate elderly population using cone-beam computed tomography. Surg Radiol Anat 2013; 36:643-9. [PMID: 24292424 DOI: 10.1007/s00276-013-1241-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 11/19/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE The loss of teeth considerably modifies the mandibular shape. The aim of this study was to compare the morphological changes in the mandible for dentate and totally edentate elderly subjects using cone-beam computed tomography. METHODS In total, 50 cone-beam computed tomography patients (25 dentate, 25 edentate) without any maxilla-mandibular dysmorphosis were analyzed retrospectively. Panoramic representations of the mandible with superimposed axial slices and cross-sectional slices were developed with the cone-beam computed tomography scans. Values of the mandibular cortical index, bone quality index, gonial angle, antegonial angle, antegonial depth and condyle angle in the left and right side were measured. RESULTS There was a significant difference in the mandibular cortical index between the total edentate group and the dentate group in the left side of the mandible (p < 0.001). There was a significant difference in the bone quality index between the total edentate group and the dentate group in the right side and the left side (p < 0.001). There was a significant difference in the bone quality index between the right side and the left side (p < 0.005). When comparing gender, there was only a difference in the right side (p < 0.05). CONCLUSIONS Our study concluded that the mandibular basal bone morphology changes as a consequence of tooth loss. Cone-beam computed tomography is shown to be a good tool in investigating and achieving these results.
Collapse
Affiliation(s)
- Ummühan Tozoğlu
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | |
Collapse
|
6
|
Mesa F, Souki N, Galindo-Moreno P, Velasco-Torres M, O'Valle F, Bravo M. Tobacco consumption induces alveolar crest height loss independently of mandibular bone mass and bone density. Clin Oral Implants Res 2013; 25:1034-40. [PMID: 23750807 DOI: 10.1111/clr.12207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2013] [Indexed: 11/28/2022]
Abstract
AIM To investigate the relationship of tobacco consumption with alveolar crest height (ACH) loss and mandibular bone mass estimated by digital panoramic radiography and cone-beam computed tomography (CBCT). MATERIAL AND METHODS We studied 315 patients (43.2% [n = 136] men and 56.8% [n = 179] women) with mean age of 36.6 ± 5.3 (range 21-30 years (16.2%), range 31-46 years (83.8%); 9% (n = 71) were smokers (>10 cig./day). A mean of 13.0 ± 2.0 mandibular teeth were present: 37.5% of patients had 6-12 teeth and 62.5% 13-16 teeth. We analyzed 315 digital panoramic radiographs (2D) and calculated the ACH, mandibular cortical width, and basal and alveolar bone gray level values. ACH and bone density were also measured on CBCT (3D) in the 110 patients scheduled for implantation. RESULTS In the univariate analysis, ACH loss was greater in older patients (P = 0.012) and in those with fewer mandibular teeth (P < 0.001) and showed a relationship with tobacco consumption that was close to significant (P = 0.079). In the multivariate analysis, the number of mandibular teeth (P < 0.001) and tobacco consumption (P = 0.048) were significantly associated with ACH. Alveolar and basal bone densities were associated, respectively, with number of mandibular teeth (P = 0.012) and cortical width (P = 0.030). CONCLUSION In a Caucasian population aged 21-46 years, tobacco consumption was significantly associated with ACH loss. However, ACH loss showed no significant relationship with mandibular bone mass estimated either as mandibular cortical width index or bone density on digital panoramic radiographs or as bone density on CBCT. ACH loss was a local event independent of mandibular bone mass status.
Collapse
Affiliation(s)
- Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain
| | | | | | | | | | | |
Collapse
|
7
|
Oztürk Tonguç M, Büyükkaplan US, Fentoglu O, Gümüs BA, Çerçi SS, Kirzioglu FY. Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis. Dentomaxillofac Radiol 2012; 41:509-14. [PMID: 22241867 DOI: 10.1259/dmfr/21900076] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Although several studies have addressed the relationship between systemic bone mineral status and the severity of periodontitis, there is little knowledge of the relationship between periodontal disease and locally detected bone mineral density. The aim of this study was to compare the mandibular bone mineral density of patients with chronic periodontitis with that of periodontally healthy subjects. METHODS 48 systemically healthy subjects were included in the study and underwent a periodontal examination to determine their status. 24 subjects were periodontally healthy and the other 24 had moderate or severe chronic periodontitis. The mandibular bone mineral density of the subjects was determined by dual energy X-ray absorptiometry. The region of interest on the body of the mandible was independently determined on the dual energy absorptiometry radiographs, and a computer calculated the bone mineral density of these regions. RESULTS The mandibular bone mineral density of the subjects with periodontitis was significantly lower than that of the periodontally healthy subjects (p < 0.01). There were significant negative correlations between the mandibular bone mineral density values and parameters related to the amount of periodontal destruction. CONCLUSIONS Low bone mineral density in the jaw may be associated with chronic periodontitis.
Collapse
Affiliation(s)
- M Oztürk Tonguç
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey.
| | | | | | | | | | | |
Collapse
|
8
|
Guzeldemir E, Toygar HU, Boga C, Cilasun U. Dental and periodontal health status of subjects with sickle cell disease. J Dent Sci 2011. [DOI: 10.1016/j.jds.2011.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
|
9
|
Kovačić I, Knezović Zlatarić D, Celebić A. Residual ridge atrophy in complete denture wearers and relationship with densitometric values of a cervical spine: a hierarchical regression analysis. Gerodontology 2011; 29:e935-47. [PMID: 22098144 DOI: 10.1111/j.1741-2358.2011.00589.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The rate of residual ridge atrophy (RRR) and its association with mineral density of other bones have not yet been fully explained. OBJECTIVE To measure RRR over a 5-year period in complete denture wearers and relate it to the density of a cervical spine (CSBD). MATERIALS AND METHODS Sixty-two patients (different gender, age, body mass index, duration of edentulousness (DE) and different denture-wearing habits) participated. A copper stepwedge was attached to the cassette, and 50 lateral radiograms met the criteria to be included. RESULTS A significant decrease in vertical height was observed in all measured sites. The amount of RRR was highest in frontal areas of both jaws and decreased gradually towards lateral regions. Hierarchical regression analysis revealed that the amount of RRR in the maxillary frontal area could be explained up to 48.4% by the variable DE and only up to 6.1% by the CSBD, while gender had almost no influence (1%). Similar results were obtained for the lateral maxillary RRR (33.9%; 7%; 2%), frontal mandibular RRR (40; 8.4; 0.4%) and lateral mandibular RRR (31.5%; 3.4%; 7.7%). CONCLUSION Skeletal bone density, reflecting systemic and hereditary factors, is weakly related to RRR (3.4-8.4%).
Collapse
Affiliation(s)
- Ivan Kovačić
- School of Medicine, Study of Dental Medicine, Split University, Split, Croatia
| | | | | |
Collapse
|
10
|
Mesa F, Gonzalez A, Souki N, Galindo-Moreno P, Olmo A, O'Valle F, Bravo M. Alveolar bone level is not associated with vitamin D receptor gene polymorphism and bone density in mandible. Clin Oral Investig 2011; 16:371-7. [PMID: 21394445 DOI: 10.1007/s00784-011-0536-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 02/22/2011] [Indexed: 10/18/2022]
Abstract
The objective of this study was to determine, using digital panoramic radiographs, whether the bone level at the alveolar crest is related to the mandibular bone density and/or to vitamin D receptor (VDR) gene polymorphisms. We analyzed 319 digital panoramic radiographs from the same number of patients. Alveolar bone level was expressed as percentage of root length. The mandibular cortical width index was calculated as a measure of mandibular bone density, and, in 72 randomly selected cases, the haplotype of the VDR gene (BsmL) was determined by polymerase chain reaction. Alveolar bone level was not related to the mandibular cortical width index (p = 0.568) or VDR gene expression (p = 0.575). Bone loss was greater in smokers than in non-smokers (p = 0.036), and the mandibular cortical width index was higher in males (p = 0.04), the older age group (p = 0.032), and in those with more teeth (p = 0.01). Multivariate analysis confirmed the association between these variables and alveolar bone loss. Alveolar bone loss showed no significant relationship with the mandibular bone density evaluated on digital panoramic radiographs or with VDR genotype (BsmL) in Caucasian females and males aged under 47 years.
Collapse
Affiliation(s)
- Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain.
| | | | | | | | | | | | | |
Collapse
|
11
|
Corpas LDS, Jacobs R, Quirynen M, Huang Y, Naert I, Duyck J. Peri-implant bone tissue assessment by comparing the outcome of intra-oral radiograph and cone beam computed tomography analyses to the histological standard. Clin Oral Implants Res 2010; 22:492-9. [PMID: 21143531 DOI: 10.1111/j.1600-0501.2010.02029.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The present study aims to identify radiographic methods revealing data that are most representative for the true peri-implant bone as assessed by histology. MATERIALS AND METHODS Eighty implants were placed in 10 minipigs. To assess matching between different image modalities, measurements conducted on intra-oral digital radiographs (IO), cone beam computer tomography (CBCT) and histological images were correlated using Spearman's correlation. Paired tests (Wilcoxon test) were used to determine changes in the bone parameters after 2 and 3 months of healing. RESULTS Significant correlations between bone defect depth on IO and histological slices (r= + 0.7, P<0.01), as well as on CBCT images and histological slices (r= + 0.61, P<0.01), were found. CBCT and IO images deviate, respectively, 1.20 and 1.17 mm from the histology regarding bone defects. No significant correlations were detected between fractal analysis on CBCT, intra-oral radiography and histology. For bone density assessment, significant but weaker correlations (r= + 0.5, P<0.01) were found for intra-oral radiography vs. histology. Significant marginal bone-level changes could be observed after 3 months of healing using intra-oral radiography. CONCLUSIONS This study allowed linking radiographic bone defect depth to the histological observations of the peri-implant bone. Minute bone changes during a short-term period can be followed up using digital intra-oral radiography. Radiographic fractal analysis did not seem to match histological fractal analysis. CBCT was not found to be reliable for bone density measures, but might hold potential with regard to the structural analysis of the trabecular bone.
Collapse
Affiliation(s)
- Livia dos Santos Corpas
- BIOMAT Research Group and Periodontology Department, Oral Imaging Centre Department of Dentistry, Faculty of Medicine, Catholic University of Leuven, Belgium.
| | | | | | | | | | | |
Collapse
|