INFLUENCE OF OSTEOPOROSIS AT THE LEVEL OF THE ALVEOLAR BONE IN THE FRONTAL MANDIBULAR REGION
Keywords:
osteoporosis, osteopenia, DEXA, chronic periodontitisAbstract
Osteoporosis as systematic disease has an impact on all skeletal structures, including those in the cranial and cervical regions. Patients suffering from this condition frequently experience tooth loss. Consequently, radiographic evaluation of the jawbones serves as a valuable diagnostic instrument for early detection and ongoing monitoring. For example, panoramic radiography can be utilized for screening of individuals with diminished bone mineral density. There is substantial evidence indicating that the characteristics of decreased skeletal bone mineral density can be effectively identified through dental radiographs. Bone loss associated with osteoporosis occurs throughout the body, and documenting these changes in the jawbones is advantageous, as radiographs are often performed for other dental purposes. This allows for opportunistic diagnosis prior to the occurrence of fractures, even in patients deemed to be at low risk. While dental radiography is not the exclusive diagnostic approach for osteoporosis, it serves as a complementary tool to screening methods that dentists can used for patients who may be unaware of their risk. The main objective of this research was to evaluate the presence of radiographic manifestations of periodontal disease between the osteopenic, osteoporotic group, treated osteoporotic group and non-osteoporotic group. The research encompassed four distinct groups of participants: (1) individuals without osteoporosis, (2) with osteopenia, (3) newly diagnosed and untreated osteoporotic individuals and (4) osteoporotic individuals receiving treatment. Participants were between the ages of 40 and 80 and must have undergone dual energy X-ray absorptiometry (DXA) of the proximal femur and lumbar spine within the last three months. Utilizing magnification and illumination, the distance from the cementoenamel junction to the crestal bone height at both mesial and distal interproximal sites of each tooth was measured. Digital radiographs were used to assess alveolar bone loss in the interproximal areas of the mandibular frontal region. The average measured distance between the cementoenamel junction and the limbus alveolaris in the control group was 4,248 ± 1,672 mm, in subjects with osteopenia it was 3,9841 ± 1,758 mm, in subjects with untreated osteoporosis it was 4,295 ± 1,224 mm, and finally in subjects with treated osteoporosis it was 4,766 ± 0,516 mm. Based on the processed data, we were able to observe that in people with osteoporosis who are amenable to treatment and who are untreated or the treatment has not been started, there is a significant bone reduction compared to healthy people with periodontal disease and in people with osteopenia. The most significant impact of these two conditions is on the distance from the enamel-cement junction to the limbus alveolaris. Hence, the enormous importance of timely treatment of these two diseases in order to prevent significant loss of alveolar bone is also needed.
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