Effect of Bisphosphonates on Mandibular Radiomorphometric Indices in Postmenopausal Osteoporosis Patients

Abstract

Aim: Osteoporosis is a structural failure of bone characterized by a decrease in bone mass, deterioration in its microstructure, and an increased risk of bone fragility. Bisphosphonates are potent inhibitors of bone resorption that are frequently used in disorders of bone metabolism.This study aimed to examine the effects of bisphosphonates on the mandible, using mandibular radiomorphometric indexes, in patients diagnosed with postmenopausal osteoporosis who received or did not receive bisphosphonate treatment. Material and Method: 60 female patients between the ages of 45-70 who were previously diagnosed with postmenopausal osteoporosis were included in our study. Two groups of patients were created. There were 30 patients using bisphosphonates in the first group and 30 patients not using bisphosphonates (control group) in the second group. Digital panoramic radiographs were taken from the patients, and mental index and mandibular cortical index, which are mandibular radiomorphometric indices, were measured on these radiographs. Whole body DEXA records were taken to calculate the patients’ spine bone mineral density. Results: A statistically significant difference was found in spine bone mineral density in patients using bisphosphonates compared to patients who did not use bisphosphonates (p=0.043). No statistically significant difference was detected in mental index and mandibular cortical index between patients using bisphosphonates and patients not using bisphosphonates. While the rate of determining the risk of osteoporosis of the mental index was 76.7%, the risk of osteoporosis of the mandibular cortical index was calculated as 91.7. Conclusion: Dentists can play a role in early diagnosis of osteoporosis by using the mental and mandibular cortical indexes in panoramic radiographs.

Keywords

• Biphosphonate
• dexa
• radiomorphometric indices
• postmenoposal osteoporosis

Postmenopozal Osteoporoz Hastalarında Bifosfonatların Mandibular Radyomorfometrik İndekslere Etkisi

Abstract

Amaç: Osteoporoz, kemik kütlesinde azalma, mikro yapısında bozulma ve artmış kemik kırılganlığı riskiyle karekterize, kemiğin yapısal bir yetmezliğidir. Bifosfonatlar, kemik metabolizma bozukluklarında sıklıkla kullanılan kemik rezorbsiyonunun güçlü inhibitörleridir. Bu çalışmada postmenopozal osteoporoz tanısı konmuş, bifosfonat tedavisi alan ve almayan hastaların, mandibular radyomorfometrik indekslerinin kullanımıyla bifosfonatların mandibuladaki etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza daha önce postmenopozal osteoporoz tanısı konmuş 45-70 yaş aralığında 60 kadın hasta dahil edildi. Hastalardan iki grup oluşturuldu. Birinci grupta bifosfonat kullanan 30 hasta, ikinci grupta ise bifosfonat kullanmayan (kontrol grubu) 30 hasta yer aldı. Hastalardan dijital panoramik radyografi alınarak, mandibular radyomorfometrik indekslerden mental indeks ve mandibular kortikal indeks bu radyografiler üzerinde ölçüldü. Hastaların omurga kemik mineral yoğunluklarını hesaplamak için bütün vücut DEXA kayıtları alındı. Bulgular: Bifosfonat kullanan hastalarda, kullanmayan hastalara göre omurga kemik mineral yoğunluğunda istatistiksel olarak anlamlı fark bulundu (p=0,043). Bifosfonat kullanan hastalarla kullanmayan hastalar arasında mental indekste ve mandibular kortikal indekste ise istatistiksel olarak anlamlı bir fark saptanmadı. Mental indeksin osteoporoz riskini belirleme oranı %76,7 iken mandibular kortikal indeksin osteoporoz riskini belirleme oranı ise 91,7 olarak hesaplandı. Sonuç: Diş hekimleri, panoramik radyografilerde mental indeksi ve mandibular kortikal indeksi kullanarak osteoporozun erken tanısında rol oynayabilirler.

Keywords

• Bifosfonat
• dexa
• radyomorfometrik indeks
• postmenopozal osteoporoz

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