Yajima Naoko, Munakata Motohiro, Fuchigami Kei, Sanda Minoru, Kasugai Shohei
1 Oral Implant Center, Kanagawa Dental University Hospital, Yokosuka, Japan.
2 Oral Implantology and Regenerative Dental Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
J Oral Implantol. 2017 Oct;43(5):345-349. doi: 10.1563/aaid-joi-D-17-00015. Epub 2017 Sep 5.
Rehabilitation of oral function using dental implants is clinically effective and highly predictable. Both bone quantity and quality at the implant site affect the success of the procedure. However, the effect of bisphosphonate (BP) use on mandibular bone quality has not been well documented. The purpose of this retrospective cohort study was to evaluate the bone mineral density (BMD) and cortical thickness of the mandible, as well as the influence of BP use on early implant failure. Twenty-five female patients (≥60 years of age) were selected from among 93 candidates with partially edentulous posterior mandibles. Eleven patients had received BP therapy using alendronate (BP group), and 14 patients had received alternate therapy (non-BP group). Cortical and trabecular BMD was measured using quantitative computed tomography. Cortical thickness was measured using computed tomography. The BMDs and cortical thicknesses of the two groups were compared. The results were as follows: (1) Cortical BMD was significantly higher in the BP group, (2) trabecular BMD was not affected by BP use, and (3) Cortical thickness was affected by the duration of BP use. These results indicate that BP use affects the quality and quantity of the cortical bone in the partially edentulous posterior mandible of patients with osteoporosis, which should be considered prior to treatment with dental implants in patients taking BPs.
使用牙种植体进行口腔功能康复在临床上是有效的,且具有高度可预测性。种植部位的骨量和骨质量都会影响该手术的成功率。然而,双膦酸盐(BP)的使用对下颌骨质量的影响尚未得到充分记录。这项回顾性队列研究的目的是评估下颌骨的骨矿物质密度(BMD)和皮质厚度,以及BP的使用对早期种植失败的影响。从93例下颌后牙部分缺失的候选患者中选取了25例女性患者(≥60岁)。11例患者接受了阿仑膦酸钠BP治疗(BP组),14例患者接受了替代治疗(非BP组)。使用定量计算机断层扫描测量皮质骨和小梁骨的BMD。使用计算机断层扫描测量皮质厚度。比较两组的BMD和皮质厚度。结果如下:(1)BP组的皮质BMD显著更高,(2)小梁BMD不受BP使用的影响,(3)皮质厚度受BP使用时间的影响。这些结果表明,BP的使用会影响骨质疏松症患者下颌后牙部分缺失部位皮质骨的质量和数量,在对服用BP的患者进行牙种植治疗之前应予以考虑。