Bilgili Ersen, Üçok Cemile Özlem
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Trakya University, Edirne, Turkey.
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
Oral Radiol. 2023 Jan;39(1):83-92. doi: 10.1007/s11282-022-00603-4. Epub 2022 Mar 30.
Like other bones, the mandible and cervical vertebrae are affected by several systemic diseases. The aim of this study is to evaluate the effects of osteoporosis (OP), diabetes mellitus (DM), and dialysis-indicated advanced chronic kidney disease (CKD), which are the most effective systemic diseases on the bone metabolism, on the trabecular microstructure of the mandible and cervical vertebrae using cone beam computed tomography (CBCT).
81 patients who signed our informed consent form are involved in the study. 18 of them were diagnosed with osteoporosis, 18 of them with diabetes mellitus, 18 of the patients had dialysis-indicated CKD, and 27 of them were in the control group without any systemic diseases. Nine patients in the control group, patients with CKD and patients with DM were men, and nine were women. All patients with osteoporosis and 18 of the patients in the control group were women. Using CBCT images, microstructural parameters of trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp) and volume fraction (bone volume/total volume, BV/TV) were measured.
Tb.Th and BV/TV values were higher in the control group, while Tb.Sp was higher in the osteoporosis group. The difference in BV/TV parameters was statistically significant (p = 0.02). In the DM group, Tb.Th and BV/TV values were lower and Tb.Sp values were significantly higher than in the control group (p = 0.001). In patients with advanced CKD, Tb.Th and BV/TV values were lower, while Tb.Sp values were higher than in the control group. Differences in Tb.Sp parameters were statistically significant (0.004).
Systemic diseases affect bone tissue at different levels, and to evaluate these effects, cortical and trabecular bone parts must be investigated separately, and findings must be combined with patients' clinical symptoms. CBCT is suitable for microstructural evaluation of trabecular bone and the mandible carries valuable data for this purpose.
与其他骨骼一样，下颌骨和颈椎会受到多种全身性疾病的影响。本研究的目的是使用锥形束计算机断层扫描（CBCT）评估骨质疏松症（OP）、糖尿病（DM）和透析指征的晚期慢性肾脏病（CKD）这几种对骨代谢影响最大的全身性疾病对下颌骨和颈椎小梁微观结构的影响。
81名签署了我们知情同意书的患者参与了本研究。其中18人被诊断为骨质疏松症，18人患有糖尿病，18名患者有透析指征的慢性肾脏病，27人在无任何全身性疾病的对照组中。对照组中有9名患者、慢性肾脏病患者和糖尿病患者为男性，9名患者为女性。所有骨质疏松症患者和对照组中的18名患者为女性。使用CBCT图像测量小梁厚度（Tb.Th）、小梁间距（Tb.Sp）和体积分数（骨体积/总体积，BV/TV）等微观结构参数。
对照组的Tb.Th和BV/TV值较高，而骨质疏松症组的Tb.Sp较高。BV/TV参数的差异具有统计学意义（p = 0.02）。在糖尿病组中，Tb.Th和BV/TV值较低，Tb.Sp值显著高于对照组（p = 0.001）。在晚期慢性肾脏病患者中，Tb.Th和BV/TV值较低，而Tb.Sp值高于对照组。Tb.Sp参数的差异具有统计学意义（0.004）。
全身性疾病在不同水平上影响骨组织，为评估这些影响，必须分别研究皮质骨和小梁骨部分，并且研究结果必须与患者的临床症状相结合。CBCT适用于小梁骨的微观结构评估，下颌骨为此目的承载着有价值的数据。
