¹ Clinic of Dental Prosthetic,University School of Dental Medicine, University of Belgrade; Belgrade, Serbia
²Insitute of rheumatology, Faculty of Medicine, University of Belgrade; Belgrade, Serbia
³Insitute of Radiology, University School of Dental Medicine,University of Belgrade; Belgrade, Serbia
*Corresponding author: Doc dr Srđan D. Poštić, PhD. Clinic of Dental Prosthetic, School of Dental Medicine, University of Belgrade.4, Rankeova, Belgrade, 11000, Serbia. Tel: +381-2435-719. E-mail: email@example.com
Published: September 24, 2013
Systemic osteoporosis can damage skeletal bones to different degrees or remain persistent in intensity.
The aim of this study was to determine the intensity and correlation of the osteoporotic changes in the bone density of the skeleton and body mass index (BMI) with a reduction in edentulous mandibles.
Material and Methods: In this study, 89 edentulous patients with decreased bone density comprised the experimental group, and 43 edentulous patients with normal bone densities formed the control. The age of the patients ranged between 53 and 73 years. Radiographs of the hands and panoramic radiographs were done for all the patients. The values of BMI, metacarpal index , density of lumbar spine (L2-L4), in the phalanx and segments of the mandibles as well as the heights of the edentulous alveolar ridges were measured, assessed and calculated.
Results: The lowest value of the total skeletal density was established in the osteoporotic patients on the basis of the average T-score of -2.5 in men, and - 2.6 in women. Minimum values of the heights of the edentulous ridges (right/left, in mm) were measured in both osteoporotic female (21.84/22.39) and male (24.90/24.96) patients. By comparison of the densities of the metacarpal bones, proximal phalanx, segments of the edentulous mandibles and based on the numerical values of the heights of the edentulous ridges, χ²=3.81 was found in men and χ²=4.03 was found in women with normal bone densities; χ²=5.92 was found in men and χ²=6.25 was found in women with osteopenia; χ²=2.63 was found in men and χ²=3.85 was found in women with osteoporosis, on the P level of probability of 0.05.
Conclusion: Systemic osteoporosis causes a decrease of the jawbone density and induces residual edentulous alveolar ridge reduction.
1. Kanis AJ. Osteoporosis. 2nd ed. Oxford : Blackwell Science; 1996; pp. 22-47.
2. Birdwood G. Understanding osteoporosis and its' treatment. 1st ed. New York : The Parthenon Publishing group; 1995; pp. 37-50.
3. Atwood DA. Some clinical factors related to rate of resorbtion of residual ridges. J Prosthet Dent 2001; 86(2):119-25.
4. Poštić SD. Analysis of osteoporotic changes in mandible and its’clinical significance [dissertation]. Belgrade: University School of Dental Medicine; 1998. [Dissertation in Serbian].
5. Devlin H, Feguson MWJ. Alveolar ridge resorption and mandibular atrophy. A review of the role of local and systemic factors. Br Dent J 1991; 170(3):101-4.
6. Poštić SD. Changes in mandible due to osteoporosis. Serbian Dental Journal 2007; 54(1):16-27.
7. Von Wowern N, Kollerup G. Symptomatic osteoporosis: a risk factor for residual ridge reduction of the jaws. J Prosthet Dent 1992; 67(5):656-60.
8. Klemetti E, Vainio P. Effect of bone mineral density in skeleton and mandible on extraction of teeth and clinical alveolar height. J Prosthet Dent 1993; 70(1):21-5.
9. Atwood DA, Coy WA. Clinical, cephalometric and densitometric study of reduction of residual ridges. J Prosthet Dent 1971; 26(3): 280-95.
10. Kribbs PJ, Smith DE, Chesnut CHM, Kilcoyne RF. Relationships between mandibular and skeletal bone in an osteoporotic population. J Prosthet Dent 1989; 62(6):703-7.
11. Poštić SD. Interdependence of decrease in density of mandibular osseous layers and systemic skeletal negative remodelling in view of osteoporosis. Glasnik ADJ 2006; 41: 163-76. [Article in Serbian].
12. Balcikonyte E, Balciuniene I, Alekna V. Bone mineral density and radiographic mandibular body height. Baltic Dent Maxillofac J 2003; 5:137-40.
13. Kribbs PJ. Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent 1990; 63(2):218-22.
14. Božić M, Ihan Hren N. Osteoporosis and mandibles. Dentomaxillofac Radiol 2006; 35(3):178-84.
15. Rosenquist JB, Baylink DJ, Berger JS. Alveolar atrophy and decreased skeletal bone mass of the radius. Int J Oral Surg 1978; 7(5):479-81.
16. Poštić S. Osteopenic and osteoporotic changes in a segments of mandibles. 1st ed. Belgrade: Zadužbina Andrejević; 2000. pp. 14-83. [Book in Serbian].
17. Baxter JC. Relationship of osteoporosis to excessive residual ridge resorption. J Prosthet Dent 1981; 46(2):123-25.
18. Rowe DJ. Bone loss in elderly. J Prosthet Dent 1983; 50(5):607-10.
19. Bras J, Van Ooij CP, Van der Akker HP. Mandibular atrophy and metabolic bone loss. Mandibular ridge augmentation by combined sandwich-visor osteotomy and resorption related to metabolic bone state. Int J Oral Surg 1985; 14(1):16-21.
20. Scandrett FR, Tebo HG, Miller JT, Quigley MB. Radiographic examination of the edentulous patient. I. Review of the literature and preliminary report comparing three methods. Oral Surg Oral Med Oral Pathol 1973; 35(2):266-74.
21. Klemetti E, Kroger H, Lassila V. Relationship between body mass index and the remaining alveolar ridge. J Oral Rehabil 1997; 24(11):808-12.
22. Zlatarić DK, Čelebić A, Kobler P. Relationship between body mass index and local quality of mandibular bone structure in elderly individuals. J Gerontol A Biol Sci Med Sci 2002; 57(9):M588-93.
23. Kovavić I, Celebić A, Knezović- Zlatarić D, Stipetić J, Papić M. Influence of body mass index and time of edentulousness on the residual alveolar ridge resorption in complete denture wearers. Coll Antropol 2003; 27 Suppl 2:69-74.
24. Ozola B, Slaidina A, Laurina L, Soboleva U, Lejnieks A. The influence of bone mineral density and body mass index on resorption of edentulous jaws. Stonatologia 2011; 13(1) :19-24.
25. National Institute of Health of USA. Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement 2000 March 27-29; 17(1): 1-45.
26. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001; 285(6):785-95.
27. Knezović-Zlatarić D, Čelebić A, Lazić B. Resorptive changes of maxillary and mandibular bone structures in removable denture wearers. Acta Stomatol Croat 2002; 36: 261-65.
28. Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH, Mericske-Stern R. Prosthodontic treatment for edentulous patients.12th ed. St Louis: Mosby; 2004, pp.44-45.
29. Soikkonnen K, Ainamo A, Xie Q. Height of the residual ridge and radiographic appearance of bony structure in the jaws of clinically edentulous elderly people. J Oral Rehabil 1996; 23(7):470-75.
30. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88(5):628-35.
31. Poštić SD, Krstić MS, Rakočević Z, Jevremović M, Goldner B, Pilipović NZ, Nastić M. Changes in the lower jaw in osteoporotic women patients, approach and possibilities for therapy. Acta Medica Semendrica 1998; 6:161-65. [Article in Serbian].
32. Poštić SD, Jevremović M, Rakočević Z. Mandibular and metacarpal bone densities in osteoporotic women. J Dent Res 1998; 77 (Special issue B):721.
33. Poštić SD, Krstić M, Rakočević Z. Densitometric assessment of mandibular segment and second metacarpal in osteoporotic women. J Dent Res 1998; 77 (Special issue A): 285.
34. Ural C, Bereket C, Şener I, Aktan AM, Akpinar YZ. Bone height measurement of maxillary and mandibular bones in panoramic radiographs of edentulous patients. J Clin Exp Dent 2011; 3(1):e5-9.
35. Lauriņa L, Soboļeva U. Resorption of edentulous alveolar bone. RSU Zinātniskie raksti; 208, p. 389-97.
36. Nishimura I, Hosokawa R, Atwood DA. The knife -edge tendency in mandibular residual ridges in women. J Prosthet Dent 1992; 67(6):820-26.
37. Hatipoglu H, Ozcan H, Hatipoglu U, Yuksel E. Age, sex and body mass index in relation to calvarial diploe thickness and craniometric data on MRI. Forensic Sci Int 2008; 182(1-3):46-51.
38. Ward VJ, Stephens AP, Harrison A, Lurie D. The relationship between the metacarpal index and the rate of mandibular ridge resorption. J Oral Rehabil 1977; 4(1): 83-9.
The fully formatted PDF version is available.
Int J Biomed. 2013; 3(3):201-206. © 2013 International Medical Research and Development Corporation. All rights reserved.