School of Health and Life Sciences, Serviço de Estomatologia - Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil.
J Bone Miner Metab. 2021 Mar;39(2):117-125. doi: 10.1007/s00774-020-01156-4. Epub 2020 Oct 13.
We present here a literature review focusing on the repercussions of osteoporosis on the oral and maxillofacial complex. Osteoporosis is a silent metabolic disorder characterized by reduced bone mineral density (BMD), which can lead to bone fractures, particularly affecting elderly women. The prevalence of this disease has increased significantly worldwide, and since it accelerates bone resorption also in the jaw bones, some attention has been paid to possible oral and maxillofacial manifestations.
The databases PubMed and Google Scholar were searched for reports of oral and maxillofacial changes related to osteoporosis.
Several parameters evaluating bone changes in panoramic radiography have been proposed to estimate osteoporosis-related BMD loss, but they tend to warn about the possibility of osteoporosis, rather than being diagnostic criteria. Meanwhile, it seems that osteoporosis-related BMD loss could delay alveolar bone healing and potentiate bone loss in periodontal disease.
Even though orofacial bones are not compromised by osteoporosis as much as the axial/appendicular skeleton, a regular dental follow-up of osteoporotic patients is advised, especially in the case of periodontal disease and maxillofacial surgery. Further controlled longitudinal studies considering the site-specificity of osteogenesis would be helpful regarding this issue.
本文主要探讨骨质疏松症对口颌面部复杂结构的影响。骨质疏松症是一种以骨矿物质密度降低为特征的无声代谢性疾病,易导致骨折,尤其多见于老年女性。目前,全球范围内骨质疏松症的发病率显著增加,由于该疾病会加速颌骨的骨质吸收,因此人们开始关注其可能对口颌面部产生的影响。
我们检索了 PubMed 和 Google Scholar 数据库中与骨质疏松症相关的口腔颌面部变化的报告。
已有多项评估全景片骨变化的参数被提出,用以估计与骨质疏松症相关的骨密度损失,但这些参数往往只能提示骨质疏松症的发生可能性,而非诊断标准。同时,骨质疏松症相关的骨密度损失似乎会延迟牙槽骨愈合,并加重牙周病中的骨质流失。
尽管颌面部骨骼受到骨质疏松症的影响不如轴附肢骨骼严重,但建议对骨质疏松症患者进行常规的牙科随访,尤其是在患有牙周病或接受颌面外科手术的情况下。进一步开展考虑特定部位成骨情况的对照性纵向研究可能有助于解决这一问题。