Osteoporoz ve Periodontal Hastalıklar Arasındaki İlişki Üzerine Derleme

Öz

Periodontitis ve osteoporoz, yaşlanan nüfus için önemli halk sağlığı sorunları oluşturan yaygın inflamasyonla ilişkili durumlardır. Periodontal hastalıklar, ağırlıklı olarak dento-gingival dokulardaki disbiyozis ve inflamatuvar nitelikli bir dizi bozukluktan oluşur. Osteoporoz, artan kırık riski ile birlikte kemik mineral yoğunluğu (KMY)’ nun ve yapısının bozulması ile karakterize, yaşa bağlı bir kemik hastalığıdır. Bu derlemede, osteoporoz ve periodontitis arasındaki ilişki hakkında bir güncelleme sağlamak için son 25 yıldaki literatür değerlendirilip, bunların mekanistik bağlantılarının, ortak risk faktörlerinin ve terapötik etkilerinin tartışılması amaçlanmaktadır. Sistemik ve alveolar kemik kaybı (AKK) arasındaki ilişkiyi inceleyen klinik çalışmalarda, 1996-2020 yılları arasındaki 10 araştırma, KMY ile AKK arasında ters bir korelasyon olduğunu ortaya koymuştur. Alveolar kemik kaybının radyografik olarak değerlendirilmesi önemli bir kriter olsa da, klinik ataçman kaybı (KAK); hastanın yaşamı boyunca periodontitis prognozunu yansıtan, teşhisi ve evrelendirilmesi için kritik bir ölçümdür. 1995-2020 yılları arasındaki 23 çalışmadan 17'si KAS ile osteoporoz arasında anlamlı bir ilişki olduğunu ortaya koymuştur. Her iki hastalıkta yaşa bağlı oksidatif stres ve yaşlanma, proinflamatuvar doku mikroçevresini yönlendiren ve kemik yeniden şekillenme sürecinin bozulmasına neden olan altta yatan mekanizmalardır. D vitamini eksikliği ve sigara kullanımı gibi ortak risk faktörleri bu mekanistik ilişkide önemli rol oynamaktadır. Bu faktörlerin ve aralarındaki etkileşimin anlaşılması, disiplinler arası yönetimi ve her iki hastalığa yönelik potansiyel terapötikleri incelemek için iyi kontrollü uzun dönem çalışmalar yapılmasını gerektirmektedir.

Anahtar Kelimeler

• osteoporoz
• periodontitis
• inflamasyon

A Review on the Relationship Between Osteoporosis and Periodontal Diseases

Öz

Periodontitis and osteoporosis are conditions associated with widespread inflammation that pose significant public health problems for the ageing population. Periodontal diseases consist of a series of disorders in the dento-gingival tissues that are predominantly dysbiotic and inflammatory in nature. Osteoporosis is an age- related bone disease characterised by deterioration of bone density and structure with an increased risk of fracture. This review aims to provide an update on the relationship between osteoporosis and periodontitis by evaluating the literature published in the last 25 years, followed by a discussion of their mechanistic links, common risk factors and therapeutic implications. In clinical trials examining the relationship between systemic and alveolar bone loss (ABL), all 10 studies published between 1996 and 2020 revealed an inverse correlation between systemic bone mineral density (BMD) and ABL. Although radiographic assessment of alveolar bone loss is an important criterion, CAL reflects the lifetime experience of periodontitis and is a critical measure for the diagnosis and staging of periodontitis. Of the 23 studies published between 1995 and 2020, 17 showed a significant association between CAL and osteoporosis. In both diseases, age-related oxidative stress and ageing are the underlying mechanisms that drive a pro-inflammatory tissue microenvironment, thus leading to impairment of the bone remodelling process. These mechanistic links are implicated in common risk factors such as vitamin D deficiency and smoking. Understanding these factors and their interaction requires interdisciplinary management and well-controlled longitudinal studies to examine potential therapeutics for both diseases.

Anahtar Kelimeler

• osteoporosis
• periodontitis
• inflamation

Kaynakça

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