Abstract
BackgroundBone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. In implant dentistry, bone quality is considered equivalent to bone density on radiographic assessments. The purpose of this study was to determine whether the BTM values are reflected in jawbone condition by evaluating the relationship at baseline and during follow-up in patients with prosthodontic implants.Computed tomography (CT) scans were obtained and BTM (osteocalcin, bone-specific alkaline phosphatase, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen, and crosslinked N-telopeptide of type I collagen) levels in blood samples were measured in partially edentulous eighteen patients before implant surgery. During the follow-up observation after implant surgery, marginal bone loss (MBL) was measured on dental radiography. We investigated the relationship between the presence of BTM abnormalities and radiographic bone density.ResultsMore women than men had abnormal BTM values. Bone turnover was accelerated in the group of women with abnormal BTM values. The density of cancellous bone at the implant placement site was significantly lower in the patients with abnormally high BTM values than in their counterparts with BTM values in the normal range.ConclusionsFemale patients who undergo implant treatments may have reduced bone quality; evaluations of bone strength will require assessments of both BTMs and the density of cancellous bone.
Highlights
Bone quality is as important as bone mineral density in terms of bone strength
The most popular current method of bone quality assessment is that developed by Lekholm and Zarb, who introduced a scale that ranges from 1–4 and is based on a radiographic assessment and the sensation of resistance experienced by the surgeon when preparing the implant site [3]
Osteoporosis is characterized by compromised bone strength that predisposes a patient to an increased risk of fracture [7]; this suggests that both bone quality and bone mineral density (BMD) contribute to the risk of fracture
Summary
Bone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. Bone quality is considered equivalent to bone density on radiographic assessments. The purpose of this study was to determine whether the BTM values are reflected in jawbone condition by evaluating the relationship at baseline and during follow-up in patients with prosthodontic implants. Osteoporosis is characterized by compromised bone strength that predisposes a patient to an increased risk of fracture [7]; this suggests that both bone quality and bone mineral density (BMD) contribute to the risk of fracture. Many clinical studies have indicated that the increase in BMD following treatment with anti-resorptive drugs does not reflect the proportional reduction in relative fracture risk [11], which suggests that bone quality plays an important role in bone strength. In a consensus statement issued by the National Institutes of Health, bone quality was defined by bone architecture, bone turnover, bone mineralization, and the accumulation of microdamage [7]
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