Niğde Oral and Dental Health Center, Niğde, Turkey.
Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Kayseri, Turkey.
Dentomaxillofac Radiol. 2021 Sep 1;50(6):20200505. doi: 10.1259/dmfr.20200505. Epub 2021 Feb 5.
Proton pump inhibitors (PPI) provide a long-lasting anti-acidic effect by inhibiting the proton pump, and they are one of the most commonly prescribed drugs worldwide. PPIs adversely affect the bone structure via deficiency of vitamins and minerals. The aim of this study was to investigate the possible PPI-induced bone changes in the mandible on panoramic radiographs with the methods of fractal analysis and panoramic morphometric indices.
Panoramic radiographs of 402 patients were used (201 PPI users, 201 control group). Fractal analysis was performed on 4 regions of interests (ROI): 1- upper part of the ramus, 2- angulus, 3- anterior of the mental foramen, 4- distal of the middle ramus. Also, the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) were performed on radiographs.
There were significant differences in terms of ROI3, MCW, and KI between the control and study groups ( < 0.05) while there was no significant difference for ROI1, ROI2, ROI4, and PMI ( > 0.05). Males were severely affected than females.
Osteoporotic changes were detected in the trabecular and cortical bone in the mental foramen region in PPI users with fractal analysis and morphometric indices, while there were no differences for mandibular ramus and angulus regions according to fractal analysis.
质子泵抑制剂（PPI）通过抑制质子泵来提供持久的抗酸性作用，是全球最常用的处方药物之一。PPI 会通过维生素和矿物质的缺乏对骨骼结构产生不利影响。本研究旨在通过分形分析和全景形态计量指数研究 PPI 可能在全景片上引起的下颌骨变化。
使用了 402 名患者的全景片（201 名 PPI 使用者，201 名对照组）。对 4 个感兴趣区域（ROI）进行分形分析：1- 升支上部，2- 角部，3- 颏孔前，4- 中支远端。同时，在 X 线片上还进行了全景下颌指数（PMI）、下颌皮质宽度（MCW）和 Klemetti 指数（KI）的测量。
在 ROI3、MCW 和 KI 方面，对照组和研究组之间存在显著差异（<0.05），而在 ROI1、ROI2、ROI4 和 PMI 方面则无显著差异（>0.05）。男性受影响比女性严重。
通过分形分析和形态计量指数检测到 PPI 使用者颏孔区的骨小梁和皮质骨出现骨质疏松性变化，而分形分析对下颌支和角部区域没有差异。
