Poiană Ioana Ruxandra, Dobre Ramona, Pițuru Silviu-Mirel, Bucur Alexandru
Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
J Clin Med. 2024 Aug 16;13(16):4854. doi: 10.3390/jcm13164854.
As implant treatment cases increase, many cases of failure/side effects also occur. Generally, dental clinics determine the density of the jawbone using cone beam CT (CBCT). Considering the known potential role of this tool for bone assessment in primary osteoporosis, this study evaluated patients with secondary endocrine causes of low bone mass. The study included 83 patients with endocrine causes of osteoporosis who were evaluated by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and mental foramen (MF) region CBCT. The following CBCT indices were measured: anterior (A)-thickness of inferior mandibular cortex 10 mm anterior from MF; molar (M)-thickness of inferior mandibular cortex 10 mm posterior from MF; posterior (P)-thickness of inferior mandibular cortex 25 mm posterior from MF; symphysis (S)-thickness of inferior mandibular cortex equidistant from the centers of right and left MF. The highest correlation coefficient in the secondary causes group was between the A index and the lumbar BMD (r = 0.375, = 0.001) and the P index and the femoral neck BMD (r = 0.38, = 0.001). Hypercortisolism seems to be the most predictable cause of secondary osteoporosis using the A, M, and P indices. The A, M, and P indices showed predictive values of the bone micro-architecture that was evaluated using TBS score, and were statistically significant. The symphysis index does not significantly predict osteoporosis or impaired bone micro-architecture. These findings support the potential usefulness of A, M, and P CBCT-derived radiomorphometric mandibular indices in secondary osteoporosis, underlining the well-known effects of these pathologies on bone micro-architecture rather than bone quantity.
随着种植治疗病例的增加，失败/副作用病例也屡见不鲜。一般来说，牙科诊所使用锥形束CT（CBCT）来确定颌骨密度。鉴于该工具在原发性骨质疏松症骨评估中的已知潜在作用，本研究对继发性内分泌性低骨量患者进行了评估。该研究纳入了83例因内分泌原因导致骨质疏松的患者，这些患者接受了双能X线吸收法（DXA）、骨小梁骨评分（TBS）以及颏孔（MF）区域CBCT检查。测量了以下CBCT指标：前位（A）——MF前方10mm处下颌骨下缘皮质厚度；磨牙位（M）——MF后方10mm处下颌骨下缘皮质厚度；后位（P）——MF后方25mm处下颌骨下缘皮质厚度；联合部（S）——与左右MF中心等距处下颌骨下缘皮质厚度。继发性病因组中，最高的相关系数出现在A指标与腰椎骨密度之间（r = 0.375，P = 0.001）以及P指标与股骨颈骨密度之间（r = 0.38，P = 0.001）。使用A、M和P指标时，皮质醇增多症似乎是继发性骨质疏松最可预测的病因。A、M和P指标显示出对用TBS评分评估的骨微结构具有预测价值，且具有统计学意义。联合部指数对骨质疏松或骨微结构受损无显著预测作用。这些发现支持了源自CBCT的A、M和P下颌骨放射形态计量学指标在继发性骨质疏松中的潜在用途，强调了这些病理状况对骨微结构而非骨量的众所周知的影响。
