Osteoporosis and Periodontitis

Yıl 2009, Cilt: 3 Sayı: 2, 331 - 337, 01.07.2009

Güliz N Güncü

Öz

Osteoporosis and periodontitis are diseases which affect a large number of women and men, witch incidence is increasing with age. Osteoporosis is a systemic disease while periodontitis is a local one. However, these diseases are related as both damage bone tissue and share common risk factors. There is increasing evidence that osteoporosis, and the underlying loss of bone mass characteristic of this disease, is associated with periodontal disease and tooth loss. Many possible factors contribute to the development of osteoporosis and periodontal diseases. Bisphosphonates are very frequently used to relieve patients suffering from various bone diseases, mainly bone metastases and osteoporosis. They have been associated with numerous cases of maxillary and mandibular osteonecrosis. The objective of this article is to review and summarize the published literature on the associations between osteoporosis and periodontitis and also evaluate treatment options about bisphosphonate associated osteonecrosis of the jaw

Anahtar Kelimeler

Osteoporosis, periodontitis, bisphosphonates

Osteoporoz ve Periodontitis

Öz

Osteoporoz ve periodontitis, yaşın ilerlemesiyle sıklıkla görülen ve çok sayıda erkek ve kadını etkileyen hastalıklardır. Osteoporoz sistemik, periodontitis ise lokal bir hastalıktır; ancak her ikisinde de en karakteristik bulgu kemik kaybıdır. Osteoporozun periodontal hastalıklar ve diş kayıplarıyla ilişkili olduğu düşünülmektedir. Pek çok faktör osteoporoz ve periodontal hastalıkların gelişimine katkıda bulunabilir. Bisfosfonatlar, kemik metastazları ve osteoporoz gibi kemik hastalığı olan bireylerde yaygın olarak kullanılan ilaçlardır ve son yıllarda bisfosfonat ile ilişkili çene osteonekrozları sıklıkla rapor edilmektedir. Bu derlemenin amacı osteoporoz ve periodontitis arasındaki ilişkiyi incelemek, tedavi yaklaşımlarını değerlendirmek ve bisfosfonatlara bağlı olarak oluşan çene osteonekrozlarına dikkat çekmektir

Anahtar Kelimeler

Osteoporoz, periodontitis, bisfosfonatlar

Kaynakça

• Consensus development conference: diagnosis, prophy- laxis, and treatment of osteoporosis. Am J Med. 94:646- 650, 1993.
• Drozdzowska B, Pluskiewicz W, Michno M. Tooth count in elderly women in relation to their skeletal status. Ma- turitas. 55:126-131, 2006.
• World Health Organization. Assesment of fracture risk and its application to screening for postmenopausal os- teoporosis. Report of a WHO study group. World Health Organ series, 843, 1994.
• Inaba M. Secondary osteoporosis: thyrotoxicosis, rheu- matoid arthritis, and diabetes mellitus. J Bone Miner Me- tab. 22:287-292, 2004.
• Cooper C, Coupland C, Mitchell M. Rheumatoid arthri- tis, corticosteroid therapy and hip fracture. Ann Rheum Dis. 54:49-52, 1995.
• Doga M, Mazziotti G, Bonadonna S, et al. Prevention and treatment of glucocorticoid-induced osteoporosis. J Endocrinol Invest.31:53-58, 2008.
• Geurs NC. Osteoporosis and periodontal disease. Peri- odontol 2000. 44:29-43, 2007.
• von Wowern N, Klausen B, Kollerup G. Osteoporo- sis: a risk factor in periodontal disease. J Periodontol. 65:1134-1138, 1994.
• Carranza FA. Bone Loss and Patterns of Bone Destruc- tion. Carranza FA, Newman MGC. Clinical Periodon- tology, 8th ed Philedelphia: WB Saunders Company. 297-313, 1996.
• Yoshinari N, Kawase H, Noguchi T. [The relationship between periodontal disease and osteoporosis in ani- mals]. Clin Calcium. 16:279-286, 2006.
• Cao T, Shirota T, Yamazaki M, et al. Bone mineral den- sity in mandibles of ovariectomized rabbits. Clin Oral Implants Res. 12:604-608, 2001.
• Yang J, Pham SM, Crabbe DL. Effects of oestrogen de- ficiency on rat mandibular and tibial microarchitecture. Dentomaxillofac Radiol. 32:247-251, 2003.
• Yoshihara A, Seida Y, Hanada N, Miyazaki H. A lon- gitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults. J Clin Periodontol. 31:680-684, 2004.
• Tezal M, Wactawski-Wende J, Grossi SG, et al. The re- lationship between bone mineral density and periodon- titis in postmenopausal women. J Periodontol. 71:1492- 1498, 2000.
• Wactawski-Wende J, Grossi SG, Trevisan M, et al. The role of osteopenia in oral bone loss and periodontal di- sease. J Periodontol. 67:1076-1084, 1996.
• Hildebolt CF, Pilgram TK, Dotson M, et al. Attachment loss with postmenopausal age and smoking. J Periodon- tal Res. 32:619-625, 1997.
• Mohammad AR, Bauer RL, Yeh CK. Spinal bone density and tooth loss in a cohort of postmenopausal women. Int J Prosthodont. 10:381-385, 1997.
• Krall EA, Dawson-Hughes B, Papas A, Garcia RI. Tooth loss and skeletal bone density in healthy postmenopau- sal women. Osteoporos Int. 4:104-109, 1994.
• Krall EA, Garcia RI, Dawson-Hughes B. Increased risk of tooth loss is related to bone loss at the whole body, hip, and spine. Calcif Tissue Int. 59:433-437, 1996.
• Taguchi A, Fujiwara S, Masunari N, Suzuki G. Self- reported number of remaining teeth is associated with bone mineral density of the femoral neck, but not of the spine, in Japanese men and women. Osteoporos Int. 15:842-846, 2004.
• Kribbs PJ. Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent. 63:218-222, 1990.
• Horner K, Devlin H. The relationships between two in- dices of mandibular bone quality and bone mineral density measured by dual energy X-ray absorptiometry. Dentomaxillofac Radiol. 27:17-21, 1998.
• Klemetti E, Vainio P, Lassila V, Alhava E. Cortical bone mineral density in the mandible and osteoporosis status in postmenopausal women. Scand J Dent Res. 101:219- 223, 1993.
• Klemetti E, Vainio P, Lassila V, Alhava E. Trabecular bone mineral density of mandible and alveolar height in postmenopausal women. Scand J Dent Res. 101:166- 170, 1993.
• Southard KA, Southard TE, Schlechte JA, Meis PA. The relationship between the density of the alveolar proces- ses and that of post-cranial bone. J Dent Res. 79:964- 969, 2000.
• Jeffcoat MK, Lewis CE, Reddy MS, et al. Post-menopau- sal bone loss and its relationship to oral bone loss. Peri- odontol 2000. 23:94-102, 2000.
• Kribbs PJ, Chesnut CH, 3rd, Ott SM, Kilcoyne RF. Re- lationships between mandibular and skeletal bone in a population of normal women. J Prosthet Dent. 63:86-89, 1990.
• Kutsal YG. Osteoporoz. Osteoporoz Tanısında Görüntü- leme Yöntemleri ve Histomorfometri. 81-103, 1998.
• Taguchi A, Tanimoto K, Akagawa Y, et al. Trabecular bone pattern of the mandible. Comparison of panoramic radiography with computed tomography. Dentomaxillo- fac Radiol. 26:85-89, 1997.
• Klemetti E, Kolmakov S, Heiskanen P, et al. Panoramic mandibular index and bone mineral densities in post- menopausal women. Oral Surg Oral Med Oral Pathol. 75:774-779, 1993.
• Bodur A. Osteoporoz: Çene Kemikleri ve Periodontitis İlişkisi. GÜ Dişhek Fak Derg 21:53-60, 2004.
• Jonasson G, Bankvall G, Kiliaridis S. Estimation of skele- tal bone mineral density by means of the trabecular pat- tern of the alveolar bone, its interdental thickness, and the bone mass of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 92:346-352, 2001.
• Mattson JS, Cerutis DR, Parrish LC. Osteoporosis: a re- view and its dental implications. Compend Contin Educ Dent. 23:1001-1004, 2002.
• Lopez-Marcos JF, Garcia-Valle S, Garcia-Iglesias AA. Periodontal aspects in menopausal women undergoing hormone replacement therapy. Med Oral Patol Oral Cir Bucal. 10:132-141, 2005.
• Reszka AA, Rodan GA. Bisphosphonate mechanism of action. Curr Rheumatol Rep. 5:65-74, 2005.
• Khosa AD, Nayyar MS, Beirne JC. Osteochemonecrosis of jaws and bisphosphonates. Ir Med J. 100:410-411, 2007.
• Kimmel DB. Mechanism of action, pharmacokinetic and pharmacodynamic profile, and clinical applications of nitrogen-containing bisphosphonates. J Dent Res. 86:1022-1033, 2007.
• Lin JH. Bisphosphonates: a review of their pharmacoki- netic properties. Bone. 18:75-85, 1996.
• Shoji K, Horiuchi H, Shinoda H. Inhibitory effects of a bisphosphonate (risedronate) on experimental periodon- titis in rats. J Periodontal Res. 30:277-284, 1995.
• Weinreb M, Quartuccio H, Seedor JG, et al. Histomorp- hometrical analysis of the effects of the bisphosphonate alendronate on bone loss caused by experimental perio- dontitis in monkeys. J Periodontal Res. 29:35-40, 1994.
• El-Shinnawi UM, El-Tantawy SI. The effect of alendrona- te sodium on alveolar bone loss in periodontitis (clinical trial). J Int Acad Periodontol. 5:5-10, 2003.
• Rocha M, Nava LE, Vazquez de la Torre C, et al. Clinical and radiological improvement of periodontal disease in patients with type 2 diabetes mellitus treated with alend- ronate: a randomized, placebo-controlled trial. J Perio- dontol. 72:204-209, 2001.
• Reddy MS, Geurs NC, Gunsolley JC. Periodontal host modulation with antiproteinase, anti-inflammatory, and bone-sparing agents. A systematic review. Ann Perio- dontol. 8:12-37, 2003.
• Jeffcoat MK, Cizza G, Shih WJ, et al. Efficacy of bisp- hosphonates for the control of alveolar bone loss in peri- odontitis. J Int Acad Periodontol.9:70-76, 2007.
• Marx RE, Sawatari Y, Fortin M, Broumand V. Bisphosp- honate-induced exposed bone (osteonecrosis/osteopet- rosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg. 63:1567-1575, 2005.