Osteoporosis and its relationship to oral bone loss. - Abstract - Europe PMC
Osteoporosis is defined by the World Health Organization (WHO) as a bone . The relationship between systemic and oral bone loss has also. A total of 8 electronic databases were searched to identify studies that included the following keywords: osteoporosis, periodontal disease, alveolar bone loss. The contribution of oral bone loss to the overall morbidity in the aging Bone Loss: Mandibular Bone Density and Its Relationship to Systemic Osteoporosis in .
Symptoms include pain, soft tissue swelling, infection secondary to dead bone, loosening of teeth and, in some cases, the ragged bone surfaces cause ulceration of the contacting soft tissues.
There are associated sinus tracts, and in severe cases, a cutaneous fistula may develop. A typical lesion begins in the alveolar bone and occurs more frequently in mandibular than maxillary sites by the ratio of 2: Radiographically, osteolytic changes are frequently seen and the bone lesion may appear less or more radiodense than the unaffected bone, providing a radiographic appearance similar to that observed in bone metastasis.
The disease can result in a long-term debilitating condition.
Advanced cases of BRONJ have developed pathological fractures especially in edentulous patients with long-standing oral implants [ 86 ]. Dental treatment seems to be a precipitating event in the development of most cases of BP-related osteochemonecrosis. It is therefore imperative that osteoporosis patients for whom BP therapy is being contemplated should have their dental status assessed prior to initiation of the BP therapy. This includes control of dental caries and periodontal disease, avoiding dental implant placement, using soft liners on dentures and to recommend an alternative to tooth extractions for patients with history of receiving BP therapy.
This is because withdrawal of BP therapy before major dental procedures does not appear to hasten recovery of osteonecrosis due to their persistence in bone [ 85 ]. Conclusion The effect of osteoporosis on both oral and general health needs to be well understood. As a health care provider, the dentist could serve as a pre screener of patients with the potential for osteoporosis.
Familiarity with the risk factors could aid in identifying these individuals and help in earlier diagnosis. Many of the studies conducted to date suggest there is a relationship between osteoporosis and oral health but these studies have been plagued by relatively small sample sizes and lack of adequate control of potential confounding variables such as gender, hormone intake, smoking, race, age, stress and distress, diet, body mass and exercise.
A growing body of literature has been restricted to postmenopausal women regarding the role of estrogen deficiency in the onset and progression of periodontal disease.
There is consistency of results of most studies, suggesting that an association likely does exist, but whether there is a causal nature to that association is not firmly established. Moreover, available scientific data suggest that patients with osteoporosis who are on bisphosphonates require special care during dental treatment, especially in regard to dental implants, due to a risk of occurrence of bisphosphonates related osteonecrosis of the jaw.
Further studies are needed to assess the role of osteoporosis in various oral conditions, to determine the clinical implications of osteoporosis therapies on oral health and to elucidate whether dental examination might be of value for initial screening for signs of osteoporosis. References Assessment of fracture risk and its application to screening for postmenopausal osteoporosis.
World Health Organization Scientific group on the assessment of osteoporosis at primary health care level. International Osteoporosis Foundation The facts about osteoporosis and its impact. Kanis JA Assessment of osteoporosis at the primary health care level. Prevention and Management of Osteoporosis. Osteoporosis Society of India Action plan osteoporosis: Consensus statement of an expert group, New Delhi.
Gupta A Osteoporosis in India--the nutritional hypothesis. Natl Med J India 9: Bone loss in the oral cavity is also a significant problem with age. As much as ninety four percent of United States women over sixty-five have dental bone loss.
Both osteoporosis and oral bone loss are asymptomatic and diagnosis usually is made after a problem exists. Both result in significant bone loss in middle-aged or older persons.
At the cellular level, these two diseases have many of the same pathological mechanisms that cause bone resorption. Dentists are often asked: Researchers correlated the severity of osteoporosis with the degree of residual ridge resorption.
The association between osteoporosis and oral bone loss.
Inanother study of patients with all teeth missing further confirmed that oral oral bone loss correlates with skeletal bone mass. Osteoporotic people lose more teeth than similarly matched non-osteoporotic people.
A very recent study demonstrated that the upper jaw is composed of bone structure that is more susceptible than the lower jaw. Bone changes in the jaws parallel changes found in other bones in normal aging.
Relationship Between Osteoporosis and Periodontal Disease: Review of the Literature
Bone that surrounds and supports teethThis is the only place where periodontal disease can occur. The initiation of periodontal disease does not depend on the general mineral density of the other bones in the body. Bone loss immediately around the teeth is primarily caused by local factors not present elsewhere in the body. These include bacterial plaque, calculus [mineral deposits on teeth], appliances worn, trauma, and home care.
However, one report states that individuals with osteoporosis, heavy calculus formation, and severe periodontal disease do have more tooth support loss than similar non-osteoporotic patients.
Another study states that women with high bone mineral values retain teeth with deep periodontal recession pockets longer than women with low mineral density osteoporosis. We can start protecting our bones immediately with healthy habits. One must combine dietary and lifestyle changes.
In exercise, muscle pressure stimulates the bones to absorb calcium and grow stronger. Americans spend a smaller percent of their income on food than any other nation on earth.
Such foods are generally higher in fat and sodium and lower in calcium and fiber. Fast food chains market their products in public schools through lunchroom franchises, teaching materials, and advertising contracts. Peri-implantitis was not found to be associated with osteoporosis, but peri-implantitis is a very specific class of periodontal disease with specific bacteria. Postmenopausal women with a history of osteoporotic fractures tended to have increased resorption and thinning of the mandibular inferior cortex, as compared to their matched controls.
This is a limitation of the case-control study design.
Conclusion This comprehensive literature review demonstrates the possible association between postmenopausal osteoporosis and periodontal disease: Four reasonable hypotheses for these results include destructive lifestyle risk factors, susceptible genetic factors, increased production of inflammatory mediators and less initial BMD in both systemic and oral bones.
Demonstration of a relationship between osteoporosis and periodontal disease is complex because both are multifactorial diseases sharing multiple risk factors. Specific criteria have not been established, as evidenced by the fact that 21 different assessments in a variety of combinations had been used in the studies of this review. Because these different outcome measures influence the definition of periodontal disease, determining whether periodontal disease is associated with osteoporosis may not currently be feasible.