Amorim M A L, Takayama L, Jorgetti V, Pereira R M R
Division of Rheumatology (Bone Mineral Metabolism Laboratory), University of São Paulo, São Paulo, Brazil.
Osteoporos Int. 2006 Oct;17(10):1494-500. doi: 10.1007/s00198-006-0131-0. Epub 2006 Jun 24.
In view of the increase in the life expectancy of humans and in edentulism of the population above 50 years of age, in which the prevalence of osteoporosis is also higher, it is fundamental to better understand the effects of systemic bone mass loss on the healing process of dental implants and to determine the quality of the bone that surrounds them. The objective of the present study was to compare systemic osteoporosis (axial and femoral) and parameters of mandibular bone quality, and to evaluate osseointegration in postmenopausal women receiving dental implants.
The sample consisted of 39 women aged 48-70 years, 19 with a densitometric diagnosis of osteoporosis in the lumbar spine and femoral neck and 20 controls with a normal densitometric diagnosis. Bone mineral density was measured in the patients and controls by dual-energy X-ray absorptiometry. Eighty-two osseointegrated dental implants were placed in the mandible, 39 of them in the osteoporosis group and 43 in the control group. Mandibular bone quality was evaluated by classifying mandibular inferior cortical and trabecular bone on panoramic radiographs and by histomorphometric analysis of a mandibular bone biopsy. Osseointegration was analyzed after 9 months.
No significant difference was observed between patients with osteoporosis and controls when comparing individuals with a normal cortex and those with a severely or moderately eroded cortex determined on panoramic radiographs. Histomorphometric analysis also revealed no difference in the parameters of bone formation or resorption between the two groups. Implant failure was observed in only one case.
We conclude that there is no association between systemic osteoporosis (axial and femur) and parameters of poor mandibular bone quality. The loss of one implant (1.2%) is compatible with the literature and cannot be attributed to systemic osteoporosis.
鉴于人类预期寿命的增加以及50岁以上人群无牙情况的增多,而这部分人群中骨质疏松症的患病率也较高,因此更深入地了解全身骨质流失对牙种植体愈合过程的影响并确定种植体周围骨的质量至关重要。本研究的目的是比较全身骨质疏松症(脊柱和股骨)与下颌骨质量参数,并评估接受牙种植体的绝经后女性的骨整合情况。
样本包括39名年龄在48 - 70岁之间的女性,其中19名经骨密度测量诊断为腰椎和股骨颈骨质疏松症,20名作为骨密度测量诊断正常的对照组。通过双能X线吸收法测量患者和对照组的骨矿物质密度。在下颌骨植入82颗骨整合牙种植体,其中39颗植入骨质疏松症组,43颗植入对照组。通过全景X线片对下颌骨皮质下和小梁骨进行分类以及对下颌骨活检进行组织形态计量分析来评估下颌骨质量。9个月后分析骨整合情况。
在比较全景X线片上皮质正常者与皮质严重或中度侵蚀者时,骨质疏松症患者与对照组之间未观察到显著差异。组织形态计量分析也显示两组之间骨形成或吸收参数无差异。仅观察到1例种植体失败。
我们得出结论,全身骨质疏松症(脊柱和股骨)与下颌骨质量差的参数之间没有关联。1颗种植体的失败率(1.2%)与文献报道相符,不能归因于全身骨质疏松症。