1
|
Heuchert J, Kozieł S, Spinek AE. Radiomorphometric indices of the mandible as indicators of decreased bone mineral density and osteoporosis - meta-analysis and systematic review. Osteoporos Int 2024; 35:401-412. [PMID: 37870561 PMCID: PMC10867062 DOI: 10.1007/s00198-023-06949-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
This review aims to evaluate the accuracy of various mandibular radiomorphometric indices in comparison with DEXA BMD measurements in the diagnosis of osteopenia and osteoporosis based on a meta-analysis of the sensitivity and specificity of the indices. PRISMA statement was followed. The materials for analysis were collected in August 2023 by searching three databases: PubMed Central, Web of Science, and Scopus. The selection of studies consisted of three selection stages, and 64 articles were finally obtained. Quality assessment was performed with the QUADAS-2 tool, and the general methodological quality of retrieved studies was low. Statistical analysis was performed based on 2 × 2 tables and estimated sensitivity and specificity were obtained using SROC curves. The most used indices were MCI, MCW and PMI. The best results in detecting reduced BMD obtained for MCW ≤ 3 mm, estimated sensitivity and specificity were 0.712 (95% CI, 0.477-0.870) and 0.804 (95% CI, 0.589-0.921), respectively. The most prone to the risk of bias is the MCI due to the examiner's subjectivism. Radiomorphometric indices of the mandible can be useful as a screening tool to identify patients with low BMD, but should not be used as a diagnostic method. Further research needs to focus on analysing the ability of the indices to detect osteoporosis and also in combination the indices with clinical parameters.
Collapse
Affiliation(s)
- Joanna Heuchert
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland.
| | - Sławomir Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Anna E Spinek
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| |
Collapse
|
2
|
Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
Collapse
Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
| |
Collapse
|
3
|
Prado HV, Debossan SAT, Loayza KS, Abreu LG, Brasileiro CB, Borges-Oliveira AC. Radiomorphometric indices and fractal dimension of the mandible in individuals with osteogenesis imperfecta: a matched cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:102-111. [PMID: 36966060 DOI: 10.1016/j.oooo.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/25/2023] [Accepted: 02/04/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVE The objective was to analyze radiomorphometric indices (RMIs) of mandibular cortical bone and fractal dimension (FD) of trabecular bone of individuals with osteogenesis imperfecta (OI) and compare the findings to those of individuals without OI. METHODS Digital panoramic radiographs of 20 individuals with OI (case group) and 40 individuals without OI (control group) were examined. The RMIs of mandibular cortical index (MCI) and mandibular cortical thickness (MCT) were analyzed. FD of mandibular trabecular bone was calculated bilaterally in 3 regions. The chi-squared test and paired t test were used to compare the significance of differences between the groups. The effect size and minimal clinically important difference (MCID) were also determined. Significance was established at P < .05. RESULTS Categories C2 and C3 of the MCI were more frequent in individuals with OI (P < .001). The Mean MCT was 2.08 ± 0.79 in the OI case group and 2.91 ± 0.60 in the control group (P < .001). Mean FD in the condylar region was significantly lower in the OI case group (P = .002). The effect size for these 2 measures was large, and the difference between groups was greater than the MCID. CONCLUSION Radiographs of individuals with OI exhibited more porosity and diminished thickness of the mandibular cortical bone and lower FD values in the condylar trabecular bone.
Collapse
Affiliation(s)
- Heloisa Vieira Prado
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Suélen Alves Teixeira Debossan
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Katherine Silvana Loayza
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia Borges Brasileiro
- Department of Oral Pathology and Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Borges-Oliveira
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
4
|
Diba SF, Gracea RS, Shantiningsih RR, Hidjah K. Analysis of mandible trabecular structure using digital periapical radiographs to assess low bone quality in postmenopausal women. Saudi Dent J 2021; 33:997-1003. [PMID: 34938042 PMCID: PMC8665195 DOI: 10.1016/j.sdentj.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 06/22/2021] [Accepted: 07/04/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To analyze the quality of mandibular trabecular structure in postmenopausal women using periapical radiographs. Postmenopausal women are subjected to low bone quality; hence, early detection methods are needed. In addition to bone mineral density (BMD), trabecular architecture must be assessed to determine bone quality. The mandible represents bone quality and allows the assessment of trabecular structure from periapical radiographs. MATERIAL AND METHODS Lumbar (BMDL) and femoral BMD (BMDF) examinations were performed using dual-energy X-ray absorptiometry (DXA) in 31 postmenopausal women and divided into normal, osteopenia, and osteoporotic groups. Periapical radiographs were taken at both posterior sites of the mandible. The region of interest was taken 2 mm from the apical root of the first molar. Trabecular parameters consisting of trabecular thickness (Tb.Th) and bone percentage (BA/TA) were measured using BoneJ. RESULTS Both trabecular parameters were significantly correlated with BMDF [BA/TA (r = 0.3796; p < 0.05) and Tb.Th (r = 0.508; p < 0.05)]. BA/TA and Tb.Th were significantly different between the osteoporosis and normal groups (p < 0.05) contrast to osteopenia and normal groups (p > 0.05). CONCLUSION Changes in mandibular trabeculae structure in postmenopausal women can be assessed using periapical radiographs.
Collapse
Affiliation(s)
- Silviana Farrah Diba
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rellyca Sola Gracea
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rurie Ratna Shantiningsih
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Khasnur Hidjah
- Department of Computer Science, Faculty of Engineering and Design, Universitas Bumigora, Mataram, Indonesia
| |
Collapse
|
5
|
Texturized P(VDF-TrFE)/BT membrane enhances bone neoformation in calvaria defects regardless of the association with photobiomodulation therapy in ovariectomized rats. Clin Oral Investig 2021; 26:1053-1065. [PMID: 34370100 DOI: 10.1007/s00784-021-04089-y] [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: 05/01/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this investigation was to evaluate in vivo the response of bone tissue to photobiomodulation when associated with texturized P(VDF-TrFE)/BT in calvaria defects of ovariectomized rats. MATERIALS AND METHODS Wistar Hannover rats were submitted to ovariectomy/control surgery. Calvaria bone defects of 5-mm diameter were performed after 90 days of ovariectomy. The animals were divided into OVX (without laser (L) and membrane), OVX + P(VDF-TrFE)/BT, OVX + P(VDF-TrFE)/BT + L, and OVX + PTFE + L. It was utilized a low-intensity gallium-aluminum-arsenide laser (GaAlAs) with 780-nm wavelength and 30-J/cm2 energy density in 12 sessions (120 s). Thirty days after the bone defect the animals were euthanized for histological, microtomographic, and molecular evaluation. Quantitative analysis was analyzed by statistical software for p < 0.05. RESULTS Histological parameters showed bone tissue formation at the borders of all group defects. The association of photobiomodulation and texturized P(VDF-TrFE)/BT was not synergistic and did not show significant changes in morphometric analysis and biomarkers gene expression. Nevertheless, texturized P(VDF-TrFE)/BT membrane enhanced bone repair regardless of the association with photobiomodulation therapy, with an increase of connectivity density when compared to the OVX + PTFE + L group. The association of photobiomodulation therapy and PTFE was synergistic, increasing the expression of Runx2, Alp, Bsp, Bglap, Sp7, and Rankl, even though not enough to reflect significance in the morphometric parameters. CONCLUSIONS The utilization of texturized P (VDF-TrFE)/BT, regardless of the association with photobiomodulation therapy, enhanced bone repair in an experimental model of osteoporosis.
Collapse
|
6
|
Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis. Oral Radiol 2021; 37:189-208. [PMID: 33620644 DOI: 10.1007/s11282-021-00518-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Osteoporotic fractures are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. We undertook a worldwide literature survey and present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. In addition, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. These incidental findings on panoramic radiographs, when used for identifying asymptomatic postmenopausal female patients at risk of having osteoporosis in general dental practice, may be helpful in reducing the incidence of first fractures, with a consequent reduction in the secondary fractures, medical costs, and mortality associated with osteoporotic fragility fractures, without incurring any additional cost.
Collapse
|
7
|
Ayed MS, Shafiq SS, Diab HM, Alahmari AD, Divakar DD. Assessing periapical dental radiographs as a screening parameter for early indications of osteoporosis in postmenopausal periodontal patients and root surface evaluation using spectrochemical analysis. Saudi Med J 2018; 39:719-724. [PMID: 29968896 PMCID: PMC6146264 DOI: 10.15537/smj.2018.7.22453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: To assess the usefulness of periapical dental radiograph as a screening tool aimed at early signs of osteoporosis in postmenopausal periodontal patients and root surface evaluation using spectrochemical analysis. Methods: This study was conducted at the Department of Periodontics, Riyadh Elm University, Riyadh, Saudi Arabia, for 12 months between December 2016 and November 2017. Two groups consisted healthy postmenopausal women having chronic periodontitis and postmenopausal women having chronic periodontitis with osteoporosis. Osteoporosis were evaluated for plaque index (PI); gingival index (GI); clinical attachment level (CAL); probing pocket depth (PPD), and bone mineral density (BMD). A standardized digital dental periapical radiographs were taken for every patient. The spectrochemical analysis was carried out using the self-assembled Laser-Induced Breakdown Spectroscopy (LIBS) system used for qualitative and quantitative analysis of Calcium (Ca), Potassium (K), Phosphorus (P), Fluoride (F), and Magnesium (Mg) Results: There was no statistically significant difference between both groups for GI and PI. Similarly PPD and CAL were showing the difference but statistically, significant difference was only for CAL. Value of distance starting from cement enamel junction to the alveolar crest (CEJ-AC) and BMD were having a statistically significant variance between both groups. The differences between osteoporotic and control group were statistically significant regarding Ca with the mean higher in the control group. Furthermore, the variances between the groups in both K and Mg were statistically significant with higher mean in the osteoporotic group (p<0.05). Conclusion: The clinical, radiographic, and experimental findings of this study indicated that osteoporosis has a direct effect on the progression rate of periodontal tissue destruction and dental radiographic can be suggested as a screening tool for an early sign of osteoporosis.
Collapse
|
8
|
Zhou P, Wu G, Zhang P, Xu R, Ge J, Fu Y, Zhang Y, Du Y, Ye J, Cheng J, Jiang H. SATB2-Nanog axis links age-related intrinsic changes of mesenchymal stem cells from craniofacial bone. Aging (Albany NY) 2017; 8:2006-2011. [PMID: 27632702 PMCID: PMC5076449 DOI: 10.18632/aging.101041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/02/2016] [Indexed: 12/14/2022]
Abstract
Bone mesenchymal stem cells (BMSCs) senescence contributes to age-related bone loss. The alveolar bone in jaws originates from neural crest cells and possesses significant site- and age-related properties. However, such intrinsic characteristics of BMSCs from alveolar bone (AB-BMSCs) and the underlying regulatory mechanisms still remain unknown. Here, we found that the expression of special AT-rich binding protein 2 (SATB2) in human AB-BMSCs significantly decreased with aging. SATB2 knockdown on AB-BMSCs from young donors displayed these aging-related phenotypes in vitro. Meanwhile, enforced SATB2 overexpression could rejuvenate AB-BMSCs from older donors. Importantly, satb2 gene- modified BMSCs therapy could prevent the alveolar bone loss during the aging of rats. Mechanistically, the stemness regulator Nanog was identified as the direct transcriptional target of SATB2 in BMSCs and functioned as a downstream mediator of SATB2. Collectively, our data reveal that SATB2 in AB-BMSCs associates with their age-related properties, and prevents AB-BMSCs senescence via maintaining Nanog expression. These findings highlight the translational potential of transcriptional factor-based cellular reprogramming for anti-aging therapy.
Collapse
Affiliation(s)
- Peipei Zhou
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China
| | - Geng Wu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China
| | - Ping Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, 210029 Nanjing, China
| | - Rongyao Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China
| | - Jie Ge
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China
| | - Yu Fu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China
| | - Yuchao Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, 210029 Nanjing, China
| | - Yifei Du
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, 210029 Nanjing, China
| | - Jinhai Ye
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, 210029 Nanjing, China
| | - Jie Cheng
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, 210029 Nanjing, China
| | - Hongbing Jiang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 210029 Nanjing, China.,Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, 210029 Nanjing, China
| |
Collapse
|
9
|
Munhoz L, Cortes ARG, Arita ES. Assessment of osteoporotic alterations in type 2 diabetes: a retrospective study. Dentomaxillofac Radiol 2017; 46:20160414. [PMID: 28186836 PMCID: PMC5606278 DOI: 10.1259/dmfr.20160414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 02/04/2017] [Accepted: 02/09/2017] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To analyze the influence of Type 2 diabetes on bone mineral density (BMD) and panoramic radiomorphometry in postmenopausal females, comparing with results from non-diabetic postmenopausal females. METHODS A total of 228 postmenopausal females (mean age: 59.51 ± 11.08 years) were included in this study. Demographics, T scores and Z scores from peripheral dual X-ray absorptiometry (DXA) and mandibular cortical index (MCI) from panoramic radiographs were assessed. Mean comparison between results for diabetics and non-diabetics was carried out with the Student's t-test. In addition, non-parametric correlations between MCI and DXA results were carried out with Spearman's test, at a level of significance of 5%. RESULTS Mean Z score values were significantly higher in diabetics than in non-diabetics (p = 0.001). T and Z score values were also significantly correlated with MCI (r = 0.428, p = 0.001, and r = 0.356, p = 0.022, respectively). CONCLUSIONS Within the limitations of this study, the present results suggest that Type 2 diabetes might increase BMD in postmenopausal females.
Collapse
Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Arthur R G Cortes
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Emiko S Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
10
|
Penoni D, Fidalgo T, Torres S, Varela V, Masterson D, Leão A, Maia L. Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis. J Dent Res 2017; 96:261-269. [DOI: 10.1177/0022034516682017] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and has been considered a risk factor for periodontal disease. The aim of this systematic review and meta-analysis was to verify the scientific evidence for the association of periodontal attachment loss with low BMD in postmenopausal women. A systematic search of the literature was performed in databases until August 2016, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria included studies that compared clinical attachment loss (CAL) between postmenopausal women with low and normal BMD. Studies using similar methodology, with lower and higher risk of bias, were pooled into 3 different meta-analyses to compare CAL among women with normal BMD, osteoporosis, and osteopenia. In the first meta-analysis, mean CAL was compared among groups. In the other 2 meta-analyses, the mean percentages of sites with CAL ≥4 mm and ≥6 mm were respectively compared among groups. From 792 unique citations, 26 articles were selected for the qualitative synthesis. Eleven of the studies were appraised as presenting low risk of bias, and the association between low BMD and CAL was observed in 10 of these studies. Thirteen cross-sectional articles were included in the meta-analysis for osteoporosis and 9 in the osteopenia analysis. Women with low BMD presented greater mean CAL than those with normal BMD (osteoporosis = 0.34 mm [95% confidence interval (CI), 0.20–0.49], P < 0.001; osteopenia = 0.07 mm [95% CI, 0.01–0.13], P = 0.02). Only studies with lower risk of bias were available for the analysis of CAL severity. Women with low BMD presented more severe attachment loss, represented as mean percentage of sites with CAL ≥4 mm (osteoporosis = 3.04 [95% CI, 1.23–4.85], P = 0.001; osteopenia = 1.74 [95% CI, 0.36–3.12], P = 0.01) and CAL ≥6 mm (osteoporosis = 5.07 [95% CI, 2.74–7.40], P < 0.001). This systematic review and meta-analysis indicates that postmenopausal women with osteoporosis or osteopenia may exhibit greater CAL compared with women with normal BMD.
Collapse
Affiliation(s)
- D.C. Penoni
- Department of Preventive Dentistry, Odontoclínica Central da Marinha, Rio de Janeiro, Brazil
- Department of Dental Clinic, Division of Periodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - T.K.S. Fidalgo
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
| | - S.R. Torres
- Department of Oral Pathology and Diagnosis, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - V.M. Varela
- Department of Dental Clinic, Division of Periodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - D. Masterson
- Central Library of the Health Science Center, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - A.T.T. Leão
- Department of Dental Clinic, Division of Periodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L.C. Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
11
|
Abstract
BACKGROUND Osteoporosis is still underdiagnosed in Germany. OBJECTIVES Is it possible to detect osteoporosis on the basis of a cone-beam computed tomography image of the mandible and several measuring methods? MATERIALS AND METHODS Sixteen cone-beam computed tomography (CBCT) images from patients of the dental clinic at the University of Ulm were reinvestigated. When the CBCT images were processed the subjects were at least 55 years old, and the mandible was completely mapped on the image. Furthermore, a dual-energy X‑ray absorptiometry scan or a CT bone mineral density test was required for every subject. The subjects were divided into an osteoporosis group and a control group. The computed tomography mental index (CTMI), the computed tomography mandibular index superior (CTI[S]) and the computed tomography mandibular index inferior (CTI[I]) were deployed for comparison of the groups. In the first instance a comparison of the osteoporosis and control groups was made for both male and female subjects. Subsequently, only the images of the female subjects were compared to each other. RESULTS A possibility for osteoporosis can be expressed at CTMI values located < 3.0 mm. As well for CTI(S) < 0.18 and CTI(I) < 0.23. There arises a 66.7 % sensitivity and 70 % specificity for the mixed subject group and an 80 % sensitivity and 57.1 % specificity for the female subject group for CTMI and CTI(S). Furthermore, there are 50.0 % sensitivity and 70 % specificity for the mixed subject group and 60.0 % sensitivity and 57.1 % specificity for the female subject group for the CTI(I). CONCLUSION CTMI, CTI(S) and CTI(I) are only suitable for osteoporosis detection to a limited extent.
Collapse
|
12
|
Barngkgei I, Halboub E, Almashraqi AA, Khattab R, Al Haffar I. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices. Imaging Sci Dent 2016; 46:185-202. [PMID: 27672615 PMCID: PMC5035724 DOI: 10.5624/isd.2016.46.3.185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 10/13/2015] [Accepted: 12/11/2015] [Indexed: 01/10/2023] Open
Abstract
Purpose The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. Materials and Methods A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. Results The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). Conclusion IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.
Collapse
Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria.; Department of Oral Medicine, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abeer Abdulkareem Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Razan Khattab
- Department of Periodontology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
| |
Collapse
|
13
|
Jagelavičienė E, Krasauskienė A, Žalinkevičius R, Vaitkevičienė I, Kubilius R. Relationship between the mandibular cortical index and calcaneal bone mineral density in postmenopausal women. MEDICINA-LITHUANIA 2016; 52:125-31. [PMID: 27170486 DOI: 10.1016/j.medici.2016.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 01/21/2016] [Accepted: 02/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE In clinical practice, a comparative analysis of bone mineral density (BMD) is carried out by examining different skeletal bones. This is useful for screening of postmenopausal osteoporosis (OP). The objective of this study was to determine the relation between the mandibular cortical index (MCI) and calcaneal BMD among postmenopausal women. MATERIALS AND METHODS The study sample included 129 randomly selected postmenopausal women aged 50-77 years. The participants were examined using panoramic radiography for the analysis of the cortical layer in the mandibular base for MCI determination and using DXL for the examination of calcaneal BMD. According to T scores, the subjects were divided into three groups (Groups 1, 2, and 3). The panoramic radiographic examination of the mandible was performed; the MCI was determined and distributed into groups (C1; C2; C3). The MCI validity in determining the calcaneus BMD status was analyzed. RESULTS The differences in BMD were statistically significant between Groups C1 and C3 (P<0.01), Groups C2 and C3 (P=0.01), and between the calcaneal BMD groups (P<0.001). There was a statistically significant inverse correlation between the MCI and calcaneal BMD (r=-0.3; P<0.001). The changes characteristic of Group C2 were documented more frequently than those of other morphological groups. The analysis of the MCI validity in BMD status showed low sensitivity (69.4%) and specificity (53.9%). CONCLUSIONS The relation between MCI and calcaneal BMD was determined. The diagnostic discrimination of the MCI was found to be not sufficient in screening the women with postmenopausal osteoporosis and its application in clinical practice might be limited.
Collapse
Affiliation(s)
- Eglė Jagelavičienė
- Department of Dental and Oral Pathology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Aurelija Krasauskienė
- Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rimantas Žalinkevičius
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Inga Vaitkevičienė
- Department of Dental and Oral Pathology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ričardas Kubilius
- Department of Maxillofacial Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
14
|
Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
|
15
|
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
|
16
|
Camargo AJ, Côrtes ARG, Aoki EM, Baladi MG, Arita ES, Watanabe PCA. Analysis of Bone Quality on Panoramic Radiograph in Osteoporosis Research by Fractal Dimension. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/am.2016.74035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
Silva EDP, Vasconcelos DFP, Marques MR, Silva MADD, Manzi FR, Barros SP. Intermittent administration of parathyroid hormone improves the repairing process of rat calvaria defects: A histomorphometric and radiodensitometric study. Med Oral Patol Oral Cir Bucal 2015; 20:e489-93. [PMID: 26034928 PMCID: PMC4523262 DOI: 10.4317/medoral.20412] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/08/2015] [Indexed: 01/30/2023] Open
Abstract
Background The aim of this study was to evaluate the effects of intermittent treatment of parathyroid hormone (PTH (1-34)) on the bone regeneration of critically-sized rat calvarial bone defects. Material and Methods Thirty-two male rats were trephined (4mm fullthickness diameter), in the central part of the parietal bones and divided into 2 groups of 16. The PTH group received subcutaneous injections of PTH (1-34) at 40µg/kg, 3 times a week and the control (CTL) group received the vehicle in the same regimen. The rats were sacrificed at 4 weeks post-treatment regimen, the parietal bones were extracted and samples were evaluated through histomorphometry and radiodensitometry. Results The histological observations showed that the PTH group presented more “island-like” new bone between the defect margins with fibrous tissues than did the CTL group. The PTH group significantly exhibited greater histologic bone formation than did the CTL group (1.5mm ±0.7; 1.9 mm ± 0.6, p<0.05/ for residual bone defect). The radiodensitometry analysis revealed significant differences among the PTH and CTL groups (2.1 Al eq. ±0.04; 1.8Al eq. ±0.06, p<0.05), demonstrating an increase in bone mineral density. The PTH treatment contributed to the bone formation with a higher amount of mineral and/or fibrous tissue when compared with the CTL group. Conclusions The results suggest that it was possible to increase the process of bone regeneration by accelerating the healing process in rat calvarial defects through intermittent administration of the PTH treatment. Key words:
Bone, skull, rats, bone regeneration, bone density.
Collapse
Affiliation(s)
- Eduardo-de-Paula Silva
- Universidade Federal do Piauí - UFPI, Campus Ministro Reis Veloso, Colegiado de Biomedicina, Av. São Sebastião, 2819, Reis Veloso, Parnaíba -PI -Brazil, 64204-035,
| | | | | | | | | | | |
Collapse
|
18
|
Calciolari E, Donos N, Park JC, Petrie A, Mardas N. A systematic review on the correlation between skeletal and jawbone mineral density in osteoporotic subjects. Clin Oral Implants Res 2015; 27:433-42. [DOI: 10.1111/clr.12597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Elena Calciolari
- Periodontology Unit; UCL Eastman Dental Institute; London UK
- Section of Periodontology, Implantology and Gnathology; Centre of Dentistry; University of Parma; Parma Italy
| | - Nikolaos Donos
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Jung-Chul Park
- Department of Periodontology; College of Dentistry; Dankook University; Cheonan South Korea
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| |
Collapse
|
19
|
Alagl AS, Bhat SG. Ascorbic acid: new role of an age-old micronutrient in the management of periodontal disease in older adults. Geriatr Gerontol Int 2014; 15:241-54. [PMID: 25407241 DOI: 10.1111/ggi.12408] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 12/28/2022]
Abstract
To review the new role of an age-old micronutrient - ascorbic acid - in the management of periodontal disease. Articles pertaining to the topic were searched in PubMed and other search engines from year 1974 to April 2014 with the following key words: "ascorbic acid," "ascorbate," "vitamin C," "periodontal disease," "gingivitis," "periodontitis," "anti-oxidants" and "elderly." Balanced nutrition is an essential factor in the elderly. Modification of nutritional requirement is important to overcome the effect of an unbalanced diet in older individuals as a result of several external and internal host-associated factors. Micronutrient requirements as aging advances could change, and require due attention. Ascorbic acid and its relationship with periodontal disease are very well known. However, recent changes in the concept of understanding the pathogenicity has led to a new path of therapeutic intervention with ascorbic acid in many chronic diseases. Oxidative stress with its associated burden might alter the disease process. In the era of "periodontal medicine," the impact of remote tissue changes on systemic disease has to be taken into serious consideration. Deficiency of nutritional impact on the host, with micronutrient vitamin C detailed in this review with sources, absorption, interaction and its relationship with systemic disease, and thereby the impact on periodontal disease. Ascorbic acid plays an important role in the aging process, and in the maintenance of periodontal health in the elderly.
Collapse
Affiliation(s)
- Adel S Alagl
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | | |
Collapse
|
20
|
Calciolari E, Donos N, Park JC, Petrie A, Mardas N. Panoramic measures for oral bone mass in detecting osteoporosis: a systematic review and meta-analysis. J Dent Res 2014; 94:17S-27S. [PMID: 25365969 DOI: 10.1177/0022034514554949] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Different quantitative and qualitative indices calculated on oral panoramic radiographs have been proposed as useful tools to screen for reduced skeletal bone mineral density (BMD). Our aim was to systematically review the literature on linear and qualitative panoramic measures and to assess the accuracy of these indices by performing a meta-analysis of their sensitivity and specificity. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was followed. Fifty studies were included in the qualitative appraisal and 19 were considered for meta-analysis. The methodological quality of the retrieved studies, assessed with the QUADAS-2 tool, was on average low. Three indices were reported by most of the studies: mandibular cortical width, panoramic mandibular index, and the Klemetti index. Mandibular cortical width presented with a better accuracy in excluding osteopenia/osteoporosis (specificity), since patients with a cortical width more than 4 mm had a normal BMD in 90% of the cases. Almost all studies used a cutoff of 0.3 for the panoramic mandibular index, resulting in an estimated sensitivity and specificity in detecting reduced BMD, respectively, of 0.723 (SE 0.160; 95% confidence interval [CI], 0.352-0.926) and 0.733 (SE 0.066; 95% CI, 0.587-0.841). The presence of any kind of mandibular cortical erosion gave an estimated sensitivity and specificity in detecting reduced BMD, respectively, of 0.789 (SE 0.031; 95% CI, 0.721-0.843) and 0.562 (SE 0.047; 95% CI, 0.47-0.651) and a sensitivity and specificity in detecting osteoporosis, respectively, of 0.806 (SE 0.105; 95% CI, 0.528-0.9200) and 0.643 (SE 0.109; 95% CI, 0.417-0.820). The mandibular cortical width, panoramic mandibular index, and Klemetti index are overall useful tools that potentially could be used by dentists to screen for low BMD. Their limitations are mainly related to the experience/agreement between different operators and the different image quality and magnification of the panoramic radiographs.
Collapse
Affiliation(s)
- E Calciolari
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - N Donos
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - J C Park
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom Department of Periodontology, College of Dentistry, Dankook University, Cheonan, South Korea
| | - A Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, United Kingdom
| | - N Mardas
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| |
Collapse
|
21
|
Lucisano MP, Nelson-Filho P, Morse L, Battaglino R, Watanabe PCA, Silva RABD, Silva LABD. Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy. Braz Oral Res 2014; 27:252-7. [PMID: 23739782 DOI: 10.1590/s1806-83242013000300005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 02/04/2013] [Indexed: 11/22/2022] Open
Abstract
Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual-energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy.
Collapse
Affiliation(s)
- Marília Pacífico Lucisano
- Department of Pediatric Clinics, Preventive and Community Dentistry, School of Dentistry of Ribeirão Preto, Univ de São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | | | | | | | | |
Collapse
|
22
|
Darcey J, Devlin H, Lai D, Walsh T, Southern H, Marjanovic E, Horner K. An observational study to assess the association between osteoporosis and periodontal disease. Br Dent J 2013; 215:617-621. [DOI: 10.1038/sj.bdj.2013.1191] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2013] [Indexed: 11/09/2022]
|
23
|
|
24
|
Yoshihara A, Iwasaki M, Miyazaki H, Nakamura K. Association between low renal function and tooth loss over 5 years. Gerodontology 2012; 31:111-6. [DOI: 10.1111/ger.12015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health and Welfare; Graduate School of Medical and Dental Sciences, Niigata University; Niigata Japan
| | - Masanori Iwasaki
- Department of Oral Health Science; Graduate School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - Hideo Miyazaki
- Department of Oral Health Science; Graduate School of Medical and Dental Sciences; Niigata University; Niigata Japan
| | - Kazutoshi Nakamura
- Department of Community Preventive Medicine; Graduate School of Medical and Dental Sciences, Niigata University; Niigata Japan
| |
Collapse
|
25
|
Arita ES, Pippa MGB, Marcucci M, Cardoso R, Cortes ARG, Watanabe PCA, Oliveira JX. Assessment of osteoporotic alterations in achondroplastic patients: a case series. Clin Rheumatol 2012. [PMID: 23179008 DOI: 10.1007/s10067-012-2126-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Achondroplasia (ACH) is the most common form of human dwarfism and has been associated with biochemical alterations of the bone tissue, also observed in cases of osteoporosis. The present case series aimed at assessing low bone density, diagnosed with spinal bone mineral density (BMD) analysis and with panoramic radiograph measurements, in ACH patients. Spinal BMD was measured by means of dual-energy X-ray absorptiometry at the lumbar region (L1-L4). On dental panoramic radiographs of the patients, the mandibular cortical width was measured separately on the right and left sides. The Klemetti Index was also assigned as appropriate for evaluating the cortical area below the mandibular foramen. Additional parameters such as patient age, gender, body mass index, and number of teeth were also recorded. BMD results showed that 5/11 cases presented with skeletal osteopenia/osteoporosis diagnoses. Additionally, mandibular cortical erosion was detected in panoramic radiographs in 8/11 cases. The BMD and panoramic radiographic alterations found in this study suggest that the diagnosis of low bone density may have a special clinical relevance in cases of bone tissue disorders, such as achondroplasia.
Collapse
Affiliation(s)
- Emiko Saito Arita
- Department of Oral Radiology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo 05508-000, Brazil.
| | | | | | | | | | | | | |
Collapse
|
26
|
Passos JS, Gomes Filho IS, Sarmento VA, Sampaio DS, Gonçalves FP, Coelho JMF, Cruz SS, Trindade SC, Cerqueira EM. Women with low bone mineral density and dental panoramic radiography. Menopause 2012; 19:704-9. [PMID: 22334058 DOI: 10.1097/gme.0b013e318240f938] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether some mandibular measurements on panoramic radiographs are associated with low bone mineral density in postmenopausal women. METHODS A sample of 122 panoramic dental radiographs and bone density tests from women 50 years or older were examined. Bone mineral density was measured in the lumbar spine and proximal femur regions through dual-energy x-ray absorptiometry. The mandibular cortical bone thickness below the mental foramen, mandibular alveolar bone resorption, and panoramic mandibular index were measured. RESULTS The mandibular cortical thickness and mandibular alveolar bone resorption showed the highest specificity (lumbar spine: 89.8% vs 73.5%, proximal femur: 83.6% vs 71.2%, respectively). The panoramic mandibular index demonstrated the highest sensitivity (lumbar spine: 43.8%; proximal femur: 40.8%). The association between the mandibular cortical thickness and bone mineral density was statistically significant even after adjustment for hormonal treatment, smoking, age at menopause, and body mass index (P = 0.04). CONCLUSIONS It is suggested that panoramic radiography may be useful for confirming individuals who present with low bone mineral density.
Collapse
|
27
|
[Osteoporosis and oral diseases]. Med Clin (Barc) 2012; 140:169-74. [PMID: 22854070 DOI: 10.1016/j.medcli.2012.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 05/22/2012] [Accepted: 05/31/2012] [Indexed: 02/02/2023]
Abstract
Osteoporosis is a major cause of fractures in elderly women. Bone densitometry is used in order to detect osteoporosis. It has been observed can also be analyzed in the jawbone. The osteoporosis may be associated with resorption of the residual ridge, periodontitis and tooth loss; also the same treatments can affect the jaws. A search was carried out in the Medline-Pubmed database in order to search the association between osteoporosis and oral diseases over the past 5 years. Forty-two articles were obtained after the selection process. The authors stated that: in reference to periodontal disease the results are conflicting, but there seems to be a higher prevalence of the disease and tooth loss and resorption of the crest. Oral bisphosphonates have little risk of causing osteonecrosis, and there is no relationship in the dental implant failure among patients taking bisphosphonates. There is no clear scientific evidence that could link osteoporosis and oral diseases.
Collapse
|
28
|
Otomo-Corgel J. Osteoporosis and osteopenia: implications for periodontal and implant therapy. Periodontol 2000 2012; 59:111-39. [DOI: 10.1111/j.1600-0757.2011.00435.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
29
|
Gomes-Filho IS, Oliveira TJS, Passos JS, Cerqueira EDMM, da Cruz SS, Barreto ML, Coelho JMF, Trindade SC, Santos CAST, Sarmento VA. Effect of osteoporosis on periodontal therapy among post-menopausal women. Gerodontology 2012; 30:40-8. [DOI: 10.1111/j.1741-2358.2012.00643.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Renvert S, Berglund J, Persson RE, Persson GR. Osteoporosis and periodontitis in older subjects participating in the Swedish National Survey on Aging and Care (SNAC-Blekinge). Acta Odontol Scand 2011; 69:201-7. [PMID: 21254955 DOI: 10.3109/00016357.2010.549501] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract Objective. We assessed the relationships between (I) ultrasonography calcaneus T-scores (PIXI) and mandibular cortex characteristics on oral panoramic radiographs in older subjects; and (II) osteoporosis and periodontitis. Material and methods. We examined 778 subjects (53% women) aged 59-96 years. Periodontitis was defined by alveolar bone loss assessed from panoramic radiographs. Results. PIXI calcaneus T-values ≤-2.5 (osteoporosis) were found in 16.3% of women and in 8.1% of men. PIXI calcaneus T-values <-1.6 (osteoporosis, adjusted) were found in 34.2% of women and in 21.4% of men. The age of the subjects and PIXI T-values were significantly correlated in women (Pearson's r = 0.37, P < 0.001) and men (Pearson's r = 0.19, P < 0.001). Periodontitis was found in 18.7% of subjects defined by alveolar bone level ≥5 mm. Subjects with osteoporosis defined by adjusted PIXI T-values had fewer remaining teeth [mean difference 4.1, 95% confidence interval (CI) -1.1 to -6.5, P < 0.001]. The crude odds ratio (OR) of an association between the panoramic assessment of mandibular cortex erosions as a sign of osteoporosis and the adjusted T-value (T-value cut-off <-1.6) was 4.8 (95% CI 3.1-7.2, P < 0.001; Pearson χ(2) = 60.1, P < 0.001). A significant OR between osteoporosis and periodontitis was only found in women for the T-value cut-off ≤-2.5 (crude OR 1.8, 95% CI 1.1-3.3, P < 0.03). Conclusions. An association between osteoporosis and periodontitis was only confirmed in women. The likelihood that the mandibular cortex index agrees with adjusted PIXI T-values is significant.
Collapse
Affiliation(s)
- Stefan Renvert
- Department of Oral Sciences , School of Health and Society, Kristianstad University, Sweden.
| | | | | | | |
Collapse
|
31
|
Fukai K, Takiguchi T, Ando Y, Aoyama H, Miyakawa Y, Ito G, Inoue M, Sasaki H. Critical tooth number without subjective dysphagia. Geriatr Gerontol Int 2011; 11:482-7. [PMID: 21702874 DOI: 10.1111/j.1447-0594.2011.00722.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To assess the critical tooth number (CTN) required for prevention of subjective dysphagia caused by oral impairments and to evaluate the relationship between this CTN and mortality. METHODS The baseline study was performed with residents aged 40-89years (n=5,643; 2224 men and 3419 women) in Miyako Islands, Okinawa, in 1987. Dental examinations were performed by dentists, and subjective dysphagia was asked. We recorded the cause and year of death of participants who died during the next 15years. RESULTS The average functional tooth number of participants with and without subjective dysphagia declined with age in both sexes. The CTN for each respective age group (40s, 50s, 60s, 70s and 80s) not including the denture group were 20.0, 17.5, 14.0, 11.8 and 10.1 in men and 19.0, 14.7, 12.7, 9.5 and 4.0 in women. These CTN were significant factors of 15-year mortality in both sexes (P<0.05). The hazard ratios were 0.72 (95% confidence interval=0.55-0.93) in men and 0.71 (0.51-0.99) in women. CONCLUSION In aged people, the minimum number of functional teeth needed to avoid subjective dysphagia might not be as high as in young people.
Collapse
Affiliation(s)
- Kakuhiro Fukai
- Fukai Institute of Health Science National Institute of Public Health, Department of Oral Health, Saitama, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Yoshihara A, Nakamura K, Miyazaki H. The association between renal function and tooth loss in Japanese community-dwelling postmenopausal women. Gerodontology 2011; 29:e363-7. [PMID: 21557761 DOI: 10.1111/j.1741-2358.2011.00481.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study examined whether low renal function is associated with the number of remaining teeth among community-dwelling elderly Japanese. BACKGROUND DATA Many elderly individuals display both low renal function and tooth loss. MATERIALS AND METHODS Subjects comprised 405 randomly selected women (55-74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross-linked N-telopeptide of type I collagen level; body mass index and smoking habits. RESULTS Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was -0.11 (p = 0.018). CONCLUSION This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.
Collapse
Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health Science, Division of Preventive Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan.
| | | | | |
Collapse
|
33
|
Evaluation of Correlation between Width and Morphology of Mandibular Inferior Cortex in Digital Panoramic Radiography and Postmenopausal Osteoporosis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2011; 13:181-6. [PMID: 22737460 PMCID: PMC3371939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 07/21/2010] [Accepted: 08/02/2010] [Indexed: 10/27/2022]
Abstract
BACKGROUND In osteoporotic patients, inferior mandibular cortex undergoes resorption which its manifestations can be detected on dental panoramic radiographs as a simple and available method. The aim of this study was to evaluate the correlation between width and morphology of mandibular inferior cortex in digital panoramic radiography and postmenopausal osteoporosis. METHODS Bone mineral density (BMD) of lumbar vertebrae and femural neck of 119 postmenopause women was assessed using DXA. Width [cortical index (CI)] and morphology [mandibular cortical index (MCI)] of inferior mandibular cortex were measured and the correlations between BMD and width and shape of the inferior mandibular cortex were evaluated. RESULTS The specificity and sensitivity in identifying women with low BMD of lumbar vertebrae by visual cortical estimation (normal or eroded) were 69.4% and 80.7% respectively. These results in identifying women with low BMD of femural neck were 67.7% and 81.5% respectively. For both sides, the threshold value that provided the highest validity (minimal false negative and false positive results) corresponded to cortical width of 4.29 mm. This threshold in lumbar vertebrae or femural neck provided a sensitivity of 81.4% (95% CI=69.1%-90.3%), specificity of 58.3% (95% CI=44.9%-70.9%), positive predictive value of 65.8% and likelihood ratio of 1.95. There were significant associations between BMD and CI and MCI. CONCLUSION Postmenopausal women with thin or eroded mandibular inferior cortex may have an increased risk for low BMD or osteoporosis.
Collapse
|
34
|
Megson E, Kapellas K, Bartold PM. Relationship between periodontal disease and osteoporosis. INT J EVID-BASED HEA 2011; 8:129-39. [PMID: 21199381 DOI: 10.1111/j.1744-1609.2010.00171.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND For many years an association between the low bone density of osteoporosis and increased risk of periodontal bone loss has been suspected. In this review the relationship between osteoporosis and periodontal disease is considered. METHODS For this narrative review a very broad search strategy of the literature was developed using both PubMed and Scopus databases using the search words "perio" and "osteoporosis". The reference lists from the selected papers were also scanned and this provided an additional source of papers for inclusion. The inclusion/exclusion criteria, were also quite liberal with only those papers dealing with bisphosphonates and osteonecrosis of the jaws, osteoporosis in edentulous individuals, as well as those not written in English being excluded. RESULTS The data available suggest that reduced bone mineral density is a shared risk factor for periodontitis rather than a causal factor. However, more prospective studies are required to fully determine what, if any, relationship truly exists between periodontitis and reduced bone mineral density. CONCLUSIONS More prospective studies are required to determine what, if any, relationships exist between periodontal disease and reduced bone mineral density.
Collapse
Affiliation(s)
- Emma Megson
- Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | | | | |
Collapse
|
35
|
|
36
|
Grant WB, Boucher BJ. Are Hill's criteria for causality satisfied for vitamin D and periodontal disease? DERMATO-ENDOCRINOLOGY 2010; 2:30-6. [PMID: 21547146 PMCID: PMC3084963 DOI: 10.4161/derm.2.1.12488] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 05/22/2010] [Accepted: 05/25/2010] [Indexed: 12/31/2022]
Abstract
There is mounting evidence that periodontal disease (PD) is linked to low serum 25-hydroxyvitamin D [25(OH)D] concentrations in addition to recognized risk factors like diet and smoking. This paper reviews this evidence using Hill's criteria for causality in a biological system. Evidence for strength of association, consistency, cohesion and 'dose-effects' [biological 'gradients'] include strong inverse correlations between serum 25(OH) and PD cross-sectionally and that PD is consistently more prevalent in darker vs. lighter skinned people and increases at higher latitudes with analogy for gingivitis and for disorders associated with PD whose risks also increase with hypovitaminosis D. Evidence for plausibility includes that vitamin D increases calcium absorption and protects bone strength; induces formation of cathelicidin and other defensins that combat bacterial infection; reduces tissue production of destructive matrix metalloproteinases actively associated with PD and that prevalence of PD varies with common vitamin D receptor polymorphisms. Experimental evidence from limited supplementation studies [using calcium and vitamin D] shows that supplementation reduces tooth loss. Thus, existing evidence for hypovitaminosis D as a risk factor for PD to date meets Hill's criteria for causality in a biological system. Further experimental evidence for effectiveness and temporality, preferably from randomized controlled trials of vitamin D supplementation [adjusting for other PD risk factors including diet and smoking to reduce confounding] are necessary to confirm causality. If confirmed, dentists and periodontists could perform a valuable service to their patients by discussing the importance of adequate vitamin D status and how to avoid deficiency.
Collapse
Affiliation(s)
- William B Grant
- Sunlight, Nutrition; and Health Research Center (SUNARC); San Francisco, CA USA
| | | |
Collapse
|