Associate Professor of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Assistant Professor of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Oral Maxillofac Surg. 2024 Aug;82(8):961-967. doi: 10.1016/j.joms.2024.03.021. Epub 2024 Mar 27.
Osteoporosis is a common disorder that is characterized by decreased bone density and increased bone resorption. This bone resorption may affect the grafted bone during the maxillofacial reconstruction.
This study aimed to measure the association between osteoporosis and resorption of anterior iliac crest bone grafts used to reconstruct the atrophic anterior maxillae.
STUDY DESIGN, SETTING, SAMPLE: This prospective cohort study included female patients requiring bone augmentation of the anterior maxilla. Patients with a ridge width of <4 mm and ridge height of >7 mm were enrolled in the study. Exclusion criteria were chronic use of corticosteroids or intravenous bisphosphonates, history of maxillofacial radiation therapy, current smoking, and underlying conditions contributing to bone metabolism (eg, hyperparathyroidism, chronic renal failure, and hypophosphatemia).
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: Osteoporosis status was a predictor variable. Patients were allocated to the osteoporosis or control group based on T-scores obtained by dual-energy x-ray absorptiometry. Mean T-scores ≤ -2.5 were assigned to the osteoporosis group.
MAIN OUTCOME VARIABLE(S): The outcome variable was graft resorption, defined as the difference in ridge width between measurements made immediately (T1) and 6 months postoperatively (T2) using cone-beam computed tomography.
Patient age, preoperative (T0) bone width, and the amount of bone augmentation, defined as the differences in ridge width between measurements made preoperatively (T0) and immediately after grafting (T1), were covariates of this study.
Descriptive, analytic, and general linear models were computed. Statistical significance was set a P < .05.
Thirty-two patients were included in the study (15 in the osteoporosis group and 17 in the control group). The amount of graft resorption at 6 months after grafting was 2.57 ± 0.59 mm in the osteoporosis group and 0.97 ± 0.59 mm in the control group (P < .001). A significant correlation was found between the mean T-score and graft resorption 6 months after grafting (P < .001).
A significant correlation was observed between osteoporosis and graft resorption in the anterior maxilla after 6 months.
骨质疏松症是一种常见的疾病，其特征是骨密度降低和骨吸收增加。这种骨吸收可能会影响颌面重建期间移植的骨头。
本研究旨在测量骨质疏松症与用于重建萎缩性上颌前部的髂前嵴骨移植物吸收之间的关系。
研究设计、地点和样本：这是一项前瞻性队列研究，包括需要在前上颌骨进行骨增强的女性患者。纳入研究的患者上颌嵴宽度<4mm 且嵴高度>7mm。排除标准为慢性使用皮质类固醇或静脉内双膦酸盐、头颈部放射治疗史、当前吸烟以及导致骨代谢异常的潜在疾病（如甲状旁腺功能亢进症、慢性肾衰竭和低磷血症）。
预测因子/暴露/自变量：骨质疏松症状况是一个预测变量。根据双能 X 射线吸收法（DXA）获得的 T 评分，患者被分配到骨质疏松症或对照组。平均 T 评分≤-2.5 被分配到骨质疏松症组。
移植骨吸收，定义为使用锥形束计算机断层扫描（CBCT）在即刻（T1）和术后 6 个月（T2）测量时嵴宽度之间的差异。
患者年龄、术前（T0）骨宽度以及骨增量，定义为术前（T0）和移植后即刻（T1）测量时嵴宽度之间的差异，为本研究的协变量。
进行描述性、分析性和一般线性模型计算。统计学显著性设置为 P<.05。
研究纳入了 32 名患者（骨质疏松症组 15 名，对照组 17 名）。移植后 6 个月时移植骨吸收量在骨质疏松症组为 2.57±0.59mm，在对照组为 0.97±0.59mm（P<.001）。发现平均 T 评分与移植后 6 个月时的移植骨吸收量之间存在显著相关性（P<.001）。
在移植后 6 个月时，在前上颌骨中观察到骨质疏松症与移植骨吸收之间存在显著相关性。
