Corcuera-Flores José R, Alonso-Domínguez Ana M, Serrera-Figallo M Ángeles, Torres-Lagares Daniel, Castellanos-Cosano Lizett, Machuca-Portillo Guillermo
Faculty of Odontology, University of Seville, Seville, Spain.
J Periodontol. 2016 Jan;87(1):14-20. doi: 10.1902/jop.2015.150229. Epub 2015 Sep 3.
Fitting implants in osteoporotic patients has traditionally been controversial, and there is little scientific evidence relating osteoporosis to marginal bone loss (MBL). The aims of this study are as follows: 1) to evaluate the possibility of a correlation between osteoporosis, as measured by the mandibular cortical index (MCI), and MBL and 2) to assess how various systemic diseases, periodontitis, and placement of implants in regenerated bone are correlated with MBL and MCI.
This retrospective study examines 212 implants inserted in 67 patients. To take a possible cluster failure into account, an implant for each patient was selected (n = 67 implants). MBL was assessed. Osteoporosis was evaluated using the MCI. Both MBL and MCI were assessed from panoramic radiographs. χ(2) test was performed (Haberman post hoc test). Significance was P <0.05.
When the total sample implant (N = 212) was evaluated, a significant association was found between the presence of osteoporosis and MCI (P <0.001) and between the presence of diabetes mellitus and MCI (P <0.01). Significant associations were also found between MBL and placement of implants in regenerated sites (P <0.001) and between MBL and a previous history of periodontitis (P <0.05). When the sample is evaluated only in selected implants (one per patient, n = 67), significant differences appear to relate only to the MBL with the placement of implants in regenerated bone sites (P <0.001).
Osteoporosis (as evaluated by MCI) does not pose a risk for the development of greater MBL. Parameters adversely affecting the development of increased MBL are a previous history of periodontitis and especially the placement of implants at sites of bone regeneration.
传统上，在骨质疏松患者中植入种植体一直存在争议，而且几乎没有科学证据表明骨质疏松与边缘骨丢失（MBL）有关。本研究的目的如下：1）评估以下颌骨皮质指数（MCI）衡量的骨质疏松与MBL之间存在相关性的可能性，以及2）评估各种全身性疾病、牙周炎和在再生骨中植入种植体如何与MBL和MCI相关。
这项回顾性研究检查了67例患者植入的212颗种植体。为了考虑可能的成组失败情况，为每位患者选择一颗种植体（n = 67颗种植体）。评估MBL。使用MCI评估骨质疏松情况。MBL和MCI均从全景X线片进行评估。进行χ²检验（哈伯曼事后检验）。显著性水平为P <0.05。
在评估全部样本种植体（N = 212）时，发现骨质疏松的存在与MCI之间存在显著关联（P <0.001），糖尿病的存在与MCI之间也存在显著关联（P <0.01）。还发现MBL与在再生部位植入种植体之间存在显著关联（P <0.001），以及MBL与既往牙周炎病史之间存在显著关联（P <0.05）。当仅对选定的种植体（每位患者一颗，n = 67）进行样本评估时，显著差异似乎仅与在再生骨部位植入种植体的MBL有关（P <0.001）。
骨质疏松（通过MCI评估）不会构成发生更大MBL的风险。对增加MBL发展产生不利影响的因素是既往牙周炎病史，尤其是在骨再生部位植入种植体。
