Gaetti-Jardim Ellen Cristina, Santiago-Junior Joel Ferreira, Goiato Marcelo Coelho, Pellizer Eduardo Piza, Magro-Filho Osvaldo, Jardim Junior Elerson Gaetti
Department of Surgery and Integrated Clinics, Araçatuba Dental School, Univ Estadual Paulista, São Paulo, Brazil.
J Craniofac Surg. 2011 May;22(3):1111-3. doi: 10.1097/SCS.0b013e3182108ec9.
Osteoporosis is a systemic disorder characterized by generalized decrease in bone mineral density. Dental implantology is a specialty with high predictability when both quantity and quality of the bone are respected. Therefore, the diagnosis and the implant treatment in patients with osteoporosis are important. In the current study, a literature review about osteoporosis and dental implant therapy was conducted. PubMed, Cochrane, ISI, Dentistry Oral Science, SciELO, and Bireme databases were consulted over the last 20 years. English- and Portuguese-language articles were included in this revision. Some authors stated that the osteoporotic bone is similar to the proposed model of bone type IV. Randomized clinical studies reported implant failure in patients with osteoporosis after menopause. Studies that contraindicate the use of implants in patients with osteoporosis infer that the impaired bone metabolism led to reduction of bone healing around the implants. Nevertheless, other authors believe that the presence of osteoporosis is not a definitive condition to contraindicate the therapy with dental implants. In these cases, the dentist should perform a proper treatment planning, modifying the implant geometry, and use larger implant diameter and with surface treatment. Thus, osteoporosis is not a contraindication for implant surgery because an accurate analysis of bone quality by means tomography is performed.
骨质疏松症是一种以骨矿物质密度普遍降低为特征的全身性疾病。当骨的数量和质量均得到重视时，牙种植学是一种具有高可预测性的专业领域。因此，骨质疏松症患者的诊断和种植治疗很重要。在当前的研究中，针对骨质疏松症和牙种植治疗进行了一项文献综述。在过去20年中查阅了PubMed、Cochrane、ISI、口腔科学牙科学、SciELO和Bireme数据库。本次综述纳入了英文和葡萄牙语文章。一些作者指出，骨质疏松性骨类似于所提出的IV型骨模型。随机临床研究报告了绝经后骨质疏松症患者的种植失败情况。那些表明骨质疏松症患者禁忌使用种植体的研究推断，受损的骨代谢导致种植体周围骨愈合减少。然而，其他作者认为，骨质疏松症的存在并非绝对禁忌牙种植治疗。在这些情况下，牙医应进行适当的治疗规划，改变种植体几何形状，并使用更大直径且经过表面处理的种植体。因此，骨质疏松症并非种植手术的禁忌证，因为可以通过断层扫描对骨质量进行准确分析。
