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在种植牙治疗前使用骨转换标志物评估颌骨质量:一项病例对照研究。

Bone turnover markers to assess jawbone quality prior to dental implant treatment: a case-control study.

作者信息

Yasuda Keisuke, Okada Shinsuke, Okazaki Yohei, Hiasa Kyou, Tsuga Kazuhiro, Abe Yasuhiko

机构信息

Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.

出版信息

Int J Implant Dent. 2020 Nov 3;6(1):67. doi: 10.1186/s40729-020-00264-0.

Abstract

BACKGROUND

Bone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. In implant dentistry, bone quality is considered equivalent to bone density on radiographic assessments. The purpose of this study was to determine whether the BTM values are reflected in jawbone condition by evaluating the relationship at baseline and during follow-up in patients with prosthodontic implants. Computed tomography (CT) scans were obtained and BTM (osteocalcin, bone-specific alkaline phosphatase, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen, and crosslinked N-telopeptide of type I collagen) levels in blood samples were measured in partially edentulous eighteen patients before implant surgery. During the follow-up observation after implant surgery, marginal bone loss (MBL) was measured on dental radiography. We investigated the relationship between the presence of BTM abnormalities and radiographic bone density.

RESULTS

More women than men had abnormal BTM values. Bone turnover was accelerated in the group of women with abnormal BTM values. The density of cancellous bone at the implant placement site was significantly lower in the patients with abnormally high BTM values than in their counterparts with BTM values in the normal range.

CONCLUSIONS

Female patients who undergo implant treatments may have reduced bone quality; evaluations of bone strength will require assessments of both BTMs and the density of cancellous bone.

摘要

背景

就骨强度而言,骨质量与骨矿物质密度同样重要。骨转换标志物(BTMs)是骨质量的临床指标。在种植牙科中,在影像学评估中骨质量被认为等同于骨密度。本研究的目的是通过评估义齿种植患者基线期及随访期的关系,来确定BTM值是否反映在颌骨状况中。在18例部分牙列缺失患者种植手术前获取计算机断层扫描(CT)图像,并测量血样中的BTM(骨钙素、骨特异性碱性磷酸酶、I型胶原吡啶交联羧基末端肽和I型胶原交联N末端肽)水平。在种植手术后的随访观察期间,通过牙科X线片测量边缘骨丢失(MBL)。我们研究了BTM异常与影像学骨密度之间的关系。

结果

BTM值异常的女性多于男性。BTM值异常的女性组骨转换加速。BTM值异常高的患者种植部位的松质骨密度显著低于BTM值在正常范围内的患者。

结论

接受种植治疗的女性患者可能骨质量降低;对骨强度的评估将需要同时评估BTMs和松质骨密度。

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