Jagelaviciene Egle, Kubilius Ricardas
Department of Dental and Oral Pathology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
Medicina (Kaunas). 2006;42(8):613-8.
Osteoporosis and periodontitis are very prevalent diseases and are most common in middle-aged and elderly women. These diseases are related as both damage bone tissue and share common risk factors. Discussions about the association between these two bone-damaging diseases began in 1960. A hypothesis was raised that systemic imbalance in bone resorption and deposition might manifest itself in the alveolar bone earlier than in other bones. When analyzing systemic and local changes in bone density, a number of issues were investigated and attempted to answer the question of whether dental osteopenia is a local manifestation of osteoporosis having similar etiology and risk factors, or it is an independent process depending primarily on factors that cause periodontal disease. Histomorphometric and microradiographic studies showed that increasing porosity of the cortical layer in mandible resulted in the decrease in bone mass. Bone strength is best expressed through bone mineral density, and it can be called a diagnostic criterion of osteoporosis. The examination of bone mineral density is called densitometry and may be performed using dual-energy x-ray absorptiometry. Orthopantomography is a method that is widely applied in odontological practice and is also informative in determining the bone density of the mandible. It can be applied when performing orthopantomographic and vertical linear measurements, as well as in determining indices in the studies of osteoporotic changes. Since many patients attend odontological clinics, nearly all of them undergo orthopantomography. This is a good possibility to investigate osteoporotic changes in the mandible, to select individuals for further studies, and to ensure clinical benefit and good treatment results.
骨质疏松症和牙周炎是非常常见的疾病,在中老年女性中最为常见。这两种疾病相互关联,因为它们都会损害骨组织并具有共同的风险因素。关于这两种骨损伤疾病之间关联的讨论始于1960年。有人提出一种假设,即骨吸收和沉积的全身失衡可能在牙槽骨中比在其他骨骼中更早地表现出来。在分析骨密度的全身和局部变化时,研究了许多问题,并试图回答以下问题:牙齿骨质减少是具有相似病因和风险因素的骨质疏松症的局部表现,还是主要取决于导致牙周疾病的因素的独立过程。组织形态计量学和显微放射学研究表明,下颌骨皮质层孔隙率增加导致骨量减少。骨强度最好通过骨矿物质密度来表示,它可以被称为骨质疏松症的诊断标准。骨矿物质密度的检查称为骨密度测定,可以使用双能X线吸收法进行。全景X线片是一种在牙科实践中广泛应用的方法,在确定下颌骨骨密度方面也很有参考价值。它可用于进行全景X线片和垂直线性测量,以及在骨质疏松症变化研究中确定指标。由于许多患者会去牙科诊所就诊,几乎所有人都要进行全景X线片检查。这是一个很好的机会来研究下颌骨的骨质疏松症变化,选择个体进行进一步研究,并确保临床获益和良好的治疗效果。