Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and Maxillofacial RadiologyOral implications of osteoporosis
Section snippets
Measurement of bone density
A number of technologies can be used to assess bone density, including single photon absorptiometry (SPA), dual photon absorptiometry (DPA), dual energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and radiographic absorptiometry (RA). The radiation doses for all techniques except QCT are low. Quantative ultrasound uses sound waves rather than ionizing radiation to assess properties of bone that are related to density and bone strength.
DXA is recognized as the best
Radiographic assessment of intraoral sites
Various tecniques have been used for assessing osteoporotic changes at intraoral sites, including SPA and DPA,7, 8, 9 DXA,10, 11, 12, 13 QCT,14, 15, 16, 17 intraoral radiographs,18, 19, 20, 21, 22 and panoramic radiographs.22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38 The majority of studies have used radiographs to assess anatomy and bone density because the costs associated with DPA, DXA, and QCT techniques, as well as access to the equipment, limit their usefulness for
Osteoporosis and its oral implications
Most studies with oral radiographic changes associated with osteoporosis have focused on measures of jawbone mass or morphology. It has been shown that mandibular BMD is correlated with skeletal bone density. Corten et al10 first suggested the use of DXA for the mandible, although their study was limited to only 4 patients. Horner et al12 were the first to carry out mandibular DXA in a clinical setting. They reported that the body of mandible may be the most appropriate site for any planned
Oral implications in the gender-related osteoporosis
Osteoporosis is more common in women than in men. Particularly, women are at greater risk for osteoporosis after menopause. Estrogen deficiency is responsible for bone loss in postmenopausal women.58 In males, hypogonadism is also clinically associated wih osteoporosis and fracture.59
Von Wowern60 has reported that the bone structure of the normal dentate jaws in older individuals is characterized by relatively thin porous cortical bone lamellae with endosteal spongiosation, as in other bones,
Oral implications of osteoporosis in the animal model
Many researchers have focused on animal models for defining the relationship between systemic and oral bone loss. Rats have constituted the most widely used animal model. An experimental study demonstrated no significant decrease in bone formation at the periosteal, endocortical, and cancellous surfaces in dentulous mandibular cross-sections between sham-operated and ovariectomized groups of aged rats.74 Tanaka et al75 indicated that estrogen deficiency in the dentulous mandibles of
Effects on oral health of medications for osteoporosis
The positive effects of estrogen-hormone replacement therapy and/or calcium and vitamin D on the postcranial skeleton are well known, however, the effects of these substances on oral bone is known less due to a lack of longitudinal studies being performed. Several studies have found that HRT has a beneficial effect on tooth loss,88, 89, 90 mandibular bone density,91 and gingival bleeding.92 Bollen et al73 did not prove any effect of hormone replacement therapy on the retention of teeth and
Conclusion
The available techniques for in vivo bone mass measurement techniques are expensive and not cost-effective to screen the general population. Recent studies have suggested that because dental panoramic radiographs are frequently made during the general practice of dentistry, the findings on such radiographs may help dentists to identify patients with undetected low BMD and refer them to medical professionals for bone densitometry.
BMD in the mandible has proven in a number of studies to be
References (96)
- et al.
Measurement of mandibular bone density ex vivo and in vivo by dual energy x-ray absorptiometry
Arch Oral Biol
(1993) - et al.
Oral findings in osteoporosis. Part I: measurement of mandibular bone density
J Prosthet Dent
(1983) - et al.
Relationships between mandibular and skeletal bone in an osteoporotic population
J Prosthet Dent
(1989) - et al.
Relationships between mandibular and skeletal bone in a population of normal women
J Prosthet Dent
(1990) Comparison of mandibular bone in normal and osteoporotic women
J Prosthet Dent
(1990)- et al.
Oral radiographs in the detection of early signs of osteoporosis
Oral Surg Oral Med Oral Pathol
(1992) - et al.
Radiographic interpretation of mandibular angular cortex: a diagnostic tool in metabolic and tooth loss. Part I. Normal state
Oral Surg Oral Med Oral Path
(1982) - et al.
Variations in adult cortical bone mass as measured by a panoramic mandibular index
Oral Surg Oral Med Oral Pathol
(1991) - et al.
Clinical bone densitometric study of mandibular atrophy using dental panoramic radiography
J Dent
(1992) - et al.
Panaromic mandibular index and bone mineral densities in postmenopausal women
Oral Surg Oral Med Oral Pathol
(1993)
Oral signs as indicators of possible osteoporosis in elderly women
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Detecting osteoporosis using dental radiographs: a comparison of four methods
J Am Dent Assoc
The relationship between mandibular bone mineral density and panoramic radiographic measurements
J Dent
Case-control study on self reported osteoporotic fractures and mandibular cortical bone
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
An in vivo comparison of diagnostic information obtained from tuned-aperture computed tomography and conventional dental radiographic imaging modalities
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Accuracy of mandibular cross-sectional imaging with tuned-aperture computed tomography (TACT), iteratively reconstructed TACT, and multidirectional, linear, and transverse panoramic tomography
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Alveolar process fractal dimension and postcranial bone density
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Fractal dimension in radiographic analysis of alveolar process bone
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Alterations of the trabecular pattern of the jaws in patients with osteoporosis
Oral Surg Oral Med Oral Pathol Oral Radio Endod
Sex-related differences in the bone mineral density of atrophic mandibles
J Prosthet Dent
Effects of ovariectomy and/or dietary calcium deficiency on bone dynamics in the rat hard palate, mandible and proximal tibia
Arch Oral Biol
The effect of ovariectomy on mandibular cortical thickness in the rat
J Dent
The effects of aging and ovariectomy on mandibular condyle in rats
J Prosthet Dent
Changes of cancellous bone mass in rat mandibular condyle following ovariectomy
Bone
Mandibular bone densty and fractal dimension in rabbits with induced osteoporosis
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Postmenopausal hormone use and tooth loss: a prospective study
J Am Dent Assoc
Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis
Am J Med
Osteoporosis prevention, diagnosis and therapy
JAMA
Osteoporosis: Review of the evidence for prevention, diagnosis, and treatment and cost-effectiveness analysis. Status report
Osteoporos Int
Special report on the official positions of the international society for clinical densitometry
Osteoporos Int
Fractures in osteoporosis: the challenge for the new millennium
Osteoporos Int
Clinical use of bone densitometry
JAMA
In vivo measurement of bone mineral content of mandibles by dualphoton absorptiometry
Scand J Dent Res
Dual-photon absorptiometry of mandibles: in vitro test of a new method
Scand J Dent Res
Bone mineral content by dualphoton absorptiometry of the mandible compared with that of the forearm and lumbar spine
Calcif Tissue Int
Interrelationships between bone mineral content measures
J Clin Periodontol
Mandibular bone mineral density as a predictor of skelatal osteoporosis
Br J Radiol
The relationships between two indices of mandibular bone quality and bone mineral density measured by dual energy X-ray absorptiometry
Dentomaxillofac Radiol
Cortical bone mineral density in the mandible and osteoporosis status in postmenopausal women
Scand J Dent Res
Quantitative computed tomography of trabecular bone in the mandible
Dentomaxillofac Radiol
Trabecular bone pattern of the mandible. Comparison panoramic radiography with computed tomography
Dentomaxillofac Radiol
Bone density in human dentate and edentulous mandibles using computed tomography
Clin Oral Impl Res
Pantomography in assessment of the osteoporosis risk group
Scand J Dent Res
Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible
Dentomaxillofac Radiol
Radiomorphometric indices of the mandible in a British female population
Dentomaxillofac Radiol
Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density
Osteoporos Int
Relationship between dental panoramic radiographic findings and biochemical markers of bone turnover
J Bone Miner Res
Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners' diagnostic performance
Osteoporos Int
Cited by (122)
Low skeletal bone mineral density as a potential aetiological factor towards idiopathic condylar resorption
2021, International Journal of Oral and Maxillofacial SurgeryPrevalence of Periapical Lesions in Patients with Osteoporosis
2021, Journal of EndodonticsSalivary Content Might be Associated With Skeletal Status in Postmenopausal Women: SilesiaOsteoActive Study Results
2021, Journal of Clinical DensitometryMucoadhesive Phenolic Pectin Hydrogels for Saliva Substitute and Oral Patch
2023, Advanced Functional MaterialsInteraction between apical periodontitis and systemic disease (Review)
2023, International Journal of Molecular Medicine