Goker Kamalı Selin, Turkaydın Dilek
J Am Dent Assoc. 2024 Dec;155(12):1022-1030. doi: 10.1016/j.adaj.2024.09.010. Epub 2024 Nov 4.
The aim of the authors was to evaluate the periapical and endodontic conditions of patients with osteoporosis and compare them with those of age- and sex-matched controls. The association between bisphosphonate (BiP) use and periapical and endodontic status in patients with osteoporosis was also investigated.
Panoramic radiographs of 711 patients with osteoporosis and 711 age- and sex-matched healthy patients were examined. The presence and number of root canal-filled teeth (RCFT), inadequate RCFT (iRCFT), and teeth with apical periodontitis (AP) were evaluated. BiP treatment history of patients with osteoporosis was also recorded.
No significant difference was observed between the osteoporosis group and control group in terms of endodontic and periapical conditions. Results of bivariate logistic regression analysis showed a positive association between the number of teeth with AP and the number of iRCFT with AP and osteoporosis, and a negative association between the number of RCFT with AP and osteoporosis. Among the patients with osteoporosis, 37.5% used BiPs, specifically alendronate, ibandronate, zoledronate, and risedronate (34.3%, 24.9%, 10.6%, 7.2%, respectively). In addition, the results showed a negative association between BiP use and RCFT.
As the number of teeth with AP and number of iRCFT with AP increased, patients were more likely to be in the osteoporosis group. These findings imply that periapical lesions may enlarge and become more detectable in patients with osteoporosis with lower bone density, and enhanced inflammatory response.
Dentists can collaborate with health care professionals to manage the overall health of patients with osteoporosis to reduce the impact of osteoporosis on oral health and effectively treat dental problems, such as AP.
作者的目的是评估骨质疏松症患者的根尖周和牙髓状况，并将其与年龄和性别匹配的对照组进行比较。还研究了双膦酸盐（BiP）的使用与骨质疏松症患者根尖周和牙髓状况之间的关联。
检查了711例骨质疏松症患者和711例年龄和性别匹配的健康患者的全景X线片。评估了根管充填牙（RCFT）、根管充填不足（iRCFT）和根尖周炎（AP）患牙的存在情况和数量。还记录了骨质疏松症患者的BiP治疗史。
骨质疏松症组和对照组在牙髓和根尖周状况方面未观察到显著差异。二元逻辑回归分析结果显示，AP患牙数量与iRCFT伴AP和骨质疏松症的数量之间呈正相关，而RCFT伴AP和骨质疏松症的数量之间呈负相关。在骨质疏松症患者中，37.5%使用了BiP，具体为阿仑膦酸盐、伊班膦酸盐、唑来膦酸盐和利塞膦酸盐（分别为34.3%、24.9%、10.6%、7.2%）。此外，结果显示BiP的使用与RCFT之间呈负相关。
随着AP患牙数量和iRCFT伴AP数量的增加，患者更有可能属于骨质疏松症组。这些发现意味着，在骨密度较低且炎症反应增强的骨质疏松症患者中，根尖周病变可能会扩大并更容易被检测到。
牙医可以与医疗保健专业人员合作，管理骨质疏松症患者的整体健康，以减少骨质疏松症对口腔健康的影响，并有效治疗牙科问题，如AP。
