Prevalence Of Bone Loss Research Articles

Radiographic bone loss around dental implants: a large-cohort, long-term follow-up revealing prevalence and predictive factors.

This retrospective study analyzed radiographic bone levels of 10,871 dental implants in a cohort of 4,247 patients over a 22-year period. The objectives of the study were to assess and explore risk factors associated with the radiographic bone level of dental implants. A longitudinal observational cohort study based on data collected from 1995 to 2019 was conducted on implants placed by a single periodontist. Inclusion criteria included both partially and fully edentulous sites. Exclusion criteria were patients who were considered ASA 3 or greater. Information on medical and dental status prior to implant placement such as diabetes and smoking were included in the analysis. Implant factors such as the implant characteristics (length and diameter) and surgical site were recorded. The outcome assessed was the prevalence of bone loss around implants and any associative factors related to the bone loss. Overall, dental implants lost an average of 0.05 ± 0.38 mm of bone 2 to 3 years after placement and 0.21 ± 0.64 mm 8 years after placement. The soft tissue condition was evaluated using the Implant Mucosal Index (IMI), and bone loss around dental implants was significantly higher when bleeding on probing was multi-point and moderate, multi-point and profuse, and when infection with suppuration was recorded. The mean difference in bone level between smokers and nonsmokers was 0.26 mm (P < .01) over a 4-year period. A mean difference of 0.10 mm (P = .04) in bone loss over 4 years was found between those with an autoimmune disease compared to those without. The diameter of the implant and immediate loading of the dental implant did not influence the radiographic bone levels over time. This large dataset of dental implants highlights predictive risk factors for bone loss around dental implants and the impact these risk factors have on the implant bone level. Consideration of these risk factors by both the dental team and the patient prior to dental implant placement will promote success of the treatment.

The impact of 4R Care Delivery Model on timing and sequence of bone density screening among patients with breast cancer.

553 Background: Bone loss is common in patients with breast cancer and can impact treatment decisions related to endocrine therapy. Hence, bone density assessment prior to starting endocrine therapy is highly important, especially because endocrine therapy is the first line adjuvant treatment for patients with ER+ breast cancer. Implementing timely bone density assessment is challenging, particularly in the early care trajectory when there are many tests and procedures taking place. We conducted a care delivery optimization in a large health system to implement bone density testing and referral for bone health consultation prior to endocrine therapy. The optimization was conducted as part of implementing the 4R Oncology model (Right Info, Right Care, Right Patient, at the Right Time), a novel approach to improving patient-facing care planning, team-based delivery and patient self-management. Here we describe the impact of this intervention. Methods: A cohort of 278 women with breast cancer who were in the 4R intervention (the 4R cohort) was compared to a historical control cohort of 201 women who received care pre-4R. Demographic, bone health history, and oncologic care data were abstracted from chart review and clinical databases. The prevalence of bone loss and timing of bone density consultation request was compared between the 4R and historical control cohorts. Results: The age, race/ethnicity and rate of ER+ cancer were similar between cohorts. Patients in the 4R cohort were significantly more likely to have received a consultation for bone density screening prior to the start of endocrine therapy (see Table). They were also more likely to receive a bone density test result during their care (Table). These findings remained significant when data were restricted to those ≥ 50 years (as a proxy for postmenopausal status) and those with ER-positive breast cancer. The rates of osteopenia and osteoporosis were similar between the cohorts: control 47%, 24%; 4R cohort: 46%, 23% respectively (data not shown). Conclusions: Care optimization using the 4R Oncology Model was associated with a significant improvement in the timing of bone density testing before initiation of endocrine therapy. The 4R Oncology Model can lead to more informed decision making in adjuvant endocrine therapy for patients with breast cancer. Additional optimizations to improve the rates of bone density tests and referrals will be beneficial.[Table: see text]

The impact of 4R Care Delivery Model on timing and sequence of bone density screening among breast cancer patients.

e24061 Background: Bone loss is common in patients with breast cancer and can impact treatment decisions related to endocrine therapy. Hence, bone density assessment prior to start of endocrine therapy is highly important, especially because endocrine therapy is recommended as the first line of adjuvant treatment in patients with ER+ breast cancer. However, implementing bone density assessment in a timely manner is challenging, particularly early in the care trajectory, which involves many specialties and includes many other tests and procedures. We conducted a care delivery optimization in a large health system to implement bone density testing and referral for bone health consultation prior to endocrine therapy. The optimization was conducted as part of implementing the 4R Oncology model (Right Info, Right Care, Right, Right Patient, at the Right Time), a novel approach to optimizing patient-facing care planning, team-based delivery and patient self-management. Here we describe the impact of this optimization. Methods: A cohort of 278 women with breast cancer who were in the 4R intervention (the 4R cohort) was compared to a historical control cohort of 201 women who received care pre-4R. Demographic, bone health history, and oncologic care data were abstracted from chart review and clinical databases. The prevalence of bone loss and timing of bone density consultation request was compared between the 4R and historical control cohorts. Results: The age, race/ethnicity and rate of ER+ cancer were similar between the cohorts. Patients in the 4R cohort were significantly more likely than those in the control cohort to have received a consultation for bone density screening prior to the start of endocrine therapy. They were also more likely to receive a bone density test result during their care. These findings remained significant when data were restricted to those ≥ 50 years (as a proxy for postmenopausal status) and those with ER-positive breast cancer. The rates of osteopenia and osteoporosis were similar between the cohorts: control 47%, 24%; 4R cohort: 46%, 23% respectively (data not shown). Conclusions: Care optimization using the 4R Oncology Model was associated with a significant improvement in the timing of bone density test before initiation of endocrine therapy. The 4R Oncology Model can lead to more informed decision making in adjuvant endocrine therapy for patients with breast cancer. Additional optimizations to improve the rates of bone density tests and referrals will be beneficial. [Table: see text]

Risk Factors for Worsening of Bone Loss in Patients Newly Diagnosed with Inflammatory Bowel Disease.

Background Bone loss is common in patients with inflammatory bowel disease (IBD). The aim of the present study was to determine the prevalence of metabolic bone disease in patients newly diagnosed with IBD and to identify the risk factors for bone loss over time. Methods We performed a retrospective, both cross-sectional and longitudinal, study to extract the risk factors of bone loss (including osteopenia and osteoporosis) in patients newly diagnosed with IBD, using dual-energy X-ray absorptiometry (DXA). Results A total of 639 patients newly diagnosed with IBD that had at least one DXA were included in the cross-sectional study. Osteopenia and osteoporosis were diagnosed in 24.6% and 5.4% of patients, respectively. Age at diagnosis, body mass index, and serum phosphorus were identified as independent factors associated with bone loss at baseline. A total of 380 of the 639 IBD patients (including 212 CD patients and 168 UC patients) with at least a second DXA scan were included in the longitudinal study. 42.6% of the patients presented a worsening of bone loss in the follow-up study. Menopause, albumin, and use of corticosteroids were identified as independent factors associated with worsening of bone loss. Conclusions Metabolic bone disease is common in IBD patients, and there is a significant increase in prevalence of bone loss over time. Postmenopausal female, malnourished patients, and those requiring corticosteroid treatment are at risk for persistent bone loss. Therefore, BMD measurements and early intervention with supplementation of calcium and vitamin D are recommended in IBD patients with high-risk factors.

Prevalence of Bone Loss in Mandibular Future Abutment Teeth among Diabetic and Non-Diabetic Patients: A Retrospective Case-Control Study

Objective: This study aimed to compare the prevalence of bone loss in lower permanent premolars and canines, which can serve as abutments for future prostheses, among diabetic and non-diabetic patients. Materials and Methods: In this retrospective case-control study, records of patients who visited the dental clinics of Imam Abdulrahman Bin Faisal University were used. Inclusion criteria were the presence of a complete periodontal chart, full mouth radiographs, and past medical history (presence of DM, hypertension, and/or coronary heart disease). The criteria for exclusion were the reporting of malignancy, pregnancy, breastfeeding, or taking of the medications that affect bone turnover, periodontal surgery within the past year, absence of radiographs with good quality, and antibiotic use within 3 months prior to the dental visit. Demographical data, including gender and age, past medical history (diabetic state), and periodontal diagnosis, were collected. The severity of periodontal disease, radiographic bone loss (RBL), and its pattern were also assessed. Results: Out of 400 records, 363 patient files were included. Of those, almost 36% were males and 64% were females. The patients’ age was ranging from 16 to 82 years. About 34% of the patients were diagnosed with generalized periodontitis while 22% had localized periodontitis. With regards to the severity of the cases, the prevalence was equally distributed between mild (37%) and moderate periodontitis (38%), while 25% were diagnosed with severe periodontitis. A total of 22% of the patients were diabetic, which showed an increase in the severity of bone loss by an average of 31% across the selected teeth (mandibular canines and premolars). The pattern of bone loss was higher in the mandibular incisors, followed by the canines and the premolars. Multiple regression models showed that non-diabetics were significantly less likely to have bone loss in all the selected teeth and the male patients had 2 times the likelihood of having bone loss. Although the mandibular canines have the highest root length in the mandible, they were the most affected by bone loss in diabetic patients with periodontitis. Conclusion: Results of this study suggested that mandibular premolars were the teeth least affected by bone loss in both, diabetic and non-diabetic groups. Therefore, they can be considered the most suitable teeth to be used as abutments for the future prosthesis.

Bone Mineral Density and Bone Remodeling in Tunisian Patients with Inflammatory Bowel Disease

Background:A high prevalence of osteopenia and osteoporosis is observed in patients with Inflammatory Bowel Disease (IBD).Objective:The aim of our study was to investigate the prevalence of bone loss, bone remodeling and risk factors in Tunisian patient with IBD.Patients and Methods:The study included 40 patients with IBD and 32 age- and sex-matched healthy controls subjects. All participants underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine. Serum levels of 25-hydroxy vitamin D (25(OH)D), parathyroid hormone (PTH), osteocalcin(OC), and urinary degradation products of C-terminal telopeptide of type I collagen (CTXI) were measured in all participants to assess the bone metabolism status.Results:Twelve (30%) patients were normal, 32.5% were osteopenic and 37.5% were osteoporotic. Osteoporosis was more frequent in IBD patients than controls (p=0.0001). Age and inflammation were associated with low bone mineral density (BMD). Mean calcium, phosphorus and alkaline phosphatase levels were similar in both groups. Median 25(OH) D levels were significantly lower in IBD patients compared with controls (p=0.0001). Median urinary CTXI levels were significantly higher in IBD patients compared with healthy controls (p=0.007). No significant differences between IBD patients and controls concerning the median serum OC and PTH levels were found.Conclusion:In our study, there is a high prevalence of low BMD in IBD patients and an increase in bone resorption without a change of bone formation. Low BMI and hypovitaminoses D were identified as risk factors for low BMD.

Prevalence of Bone Loss and the Short-Term Effect of Anti-retroviral Therapy on Bone Mineral Density in Treatment-Naïve Male Japanese Patients with HIV

Background: There have been few studies have shown the relationship between HIV and low Bone Mineral Density (BMD) in Asian countries. In particular, research on the early impact of anti-HIV drugs on BMD is scarce. Objective: We studied the prevalence of bone loss and changes of BMD after the start of Anti-Retroviral Therapy (ART) in Japanese naïve patients with HIV. Methods: Male patients with HIV who visited our hospital between 2010 and 2016 were enrolled. Patients underwent BMD analyses before and one year after ART. Changes in BMD after ART initiation were evaluated by paired t-tests. To identify clinical factors affecting BMD after ART initiation based on the BMD change ratio, multiple regression analysis was performed. Results: Thirty-one patients were followed up. By employing the T-scores in the lumbar spines and femoral necks, the prevalence of osteopenia and osteoporosis was found to be 38.7-45.2% and 6.2% respectively. There were significant BMD decreases after ART initiation. Use of Tenofovir Disoproxil Fumarate (TDF) / emtricitabine (FTC), use of Protease Inhibitors (PIs), and low CD4 cell counts were independent risk factors for lumbar spine BMD decrease. Urinary N-terminal telopeptide / creatinine was the independent risk factor for femoral neck BMD decrease. Conclusions: Low BMD was prevalent in our study cases. Low CD4 cell counts at the onset of ART initiation, TDF/FTC use, and PI use increased the risk of lumbar spine BMD decrease significantly more, while ART affected femoral neck BMD of patients with higher bone metabolic activity significantly more.

Bone loss in women with BRCA1 and BRCA2 mutations

ObjectiveEstimate the prevalence and identify risk factors for bone loss in women with BRCA mutations. MethodsWomen, age 40 and older, with BRCA mutations identified from the Breast Cancer Surveillance database at Kaiser Permanente Northern California were invited to participate and undergo a dual-energy x-ray absorptiometry scan to assess for bone loss (osteopenia or osteoporosis). Multivariable logistic regression analysis was performed to assess clinical factors associated with bone loss. ResultsOf the 238 women in the final cohort, 20 women had intact ovaries (median age 54.5years) and 218 had undergone risk reducing salpingo-oophorectomy (RRSO) (median age 57). The prevalence of bone loss was 55% in the no RRSO group and 72.5% in the RRSO group (P=0.10). In multivariable analysis, only higher body mass index (OR 0.6 per 5kg/m2, 95% CI: 0.4–0.7) and nonwhite race compared to white (OR 0.5, 95% CI: 0.2–0.9) were protective for bone loss while older age (OR 1.5 per 10years, 95% CI: 1.1–2.1) and selective estrogen receptor modulator use (3.1, 95% CI: 1.2–10.1) were associated with increased odds of bone loss. Among women with RRSO, bone loss was more frequent in women who had postmenopausal (n=106) compared to women who had premenopausal RRSO (n=112), (82.1% and 63.4% respectively, P=0.002). In multivariable analysis, only BMI was protective of bone loss (OR 0.5, 95%, CI: 0.4–0.7) but neither age nor menopausal status at RRSO were associated with bone loss. ConclusionBone loss is common in women with BRCA mutations who undergo RRSO.

Periodontitis, tooth loss and cognitive functions among older adults.

This study aims to evaluate the potential association between periodontitis, the number of teeth and cognitive functions in a cohort of older adults in Sweden. In total, 775 individuals from 60 to 99years of age were selected for the study. A clinical and radiographic examination was performed. The number of teeth and prevalence of periodontal pockets and bone loss was calculated and categorised. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE) and clock test. The education level was obtained from a questionnaire. Data were analysed using chi-square tests and multivariate logistic regression. Age and gender were associated with the prevalence of bone loss. Age and education were associated with lower number of teeth. Gender was also associated with the presence of pockets. The multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of bone loss, the number of teeth and the outcome on MMSE test. This association remained even after adjustment for age, education and gender. Tooth loss was also associated with lower outcome on clock test. Presence of periodontal pockets ≥ 5mm was not associated with cognitive test outcome. A history of periodontitis and tooth loss may be of importance for cognitive functions among older adults. Diseases with and inflammatory profile may have an impact on cognitive decline.

Marginal bone loss around implants with platform-switched Morse-cone connection: a radiographic cross-sectional study.

The aims of the present cross-sectional study are to evaluate the bone remodeling around Morse-cone implants placed subcrestally 1year after loading and the prevalence of bone loss >0.5mm after at least 3years of loading. Subjects who underwent a radiographic check in 2013 with implants that had been in function for at least 3years were considered for inclusion. The study population comprised of 145 subjects with a total of 523 implants. At the moment of insertion, all the implants were placed subcrestally from 1 to 3mm as clinically measured. Radiographs taken at baseline, that is 1year after loading (T0), and at the follow-up visit in 2013 (T1) were examined. The distance between the rim of the implant and the marginal bone level at mesial and distal aspects of each implant was determined and the mean bone loss calculated. In the total sample, the mean bone loss occurred between baseline and 2013 examination was 0.42±0.77mm; at T1 424 implants presented the marginal bone level at the implant rim (78) or above it (346). On the other hand, 99 implants presented the rim above the bone crest. Fifty-one implants that at T1 presented the rim above the bone crest, and that between T0 and T1 had lost at least 0.5mm, were considered losers: 10 implants lost up to 0.5mm, 11 lost from 0.6 to 1mm, 16 lost from 1.1 to 2mm, and 14 lost more than 2mm of bone. On a subject basis, 34 subjects (group A) with a total of 200 implant sites presented loser implants, while 111 subjects (group B) with 323 implants displayed non-loser implants. Within the limits of a cross-sectional study, the results show that Morse-cone implants placed subcrestally in the vast majority of cases (89.9%) are able to maintain the bone crest at level of the rim or above it 1year after loading. The incidence of loser sites (bone loss >0.5mm) after at least 3years of follow-up is 9.7% at implant level and 23.5% at patient level.

Natural Products from Chinese Medicines with Potential Benefits to Bone Health.

Osteoporosis is a progressive, systemic bone disorder characterized by loss of bone mass and microstructure, leading to reduced bone strength and increased risk of fracture. It is often associated with reduced quality of life and other medical complications. The disease is common in the aging population, particularly among postmenopausal women and patients who receive long-term steroidal therapy. Given the rapid growth of the aging population, increasing life expectancy, the prevalence of bone loss, and financial burden to the healthcare system and individuals, demand for new therapeutic agents and nutritional supplements for the management and promotion of bone health is pressing. With the advent of global interest in complementary and alternative medicine and natural products, Chinese medicine serves as a viable source to offer benefits for the improvement and maintenance of bone health. This review summarizes the scientific information obtained from recent literatures on the chemical ingredients of Chinese medicinal plants that have been reported to possess osteoprotective and related properties in cell-based and/or animal models. Some of these natural products (or their derivatives) may become promising leads for development into dietary supplements or therapeutic drugs.

Abstract P5-12-03: Prevalence of bone loss among nonmetastatic breast cancer patients treated with aromatase inhibitors in the United States

Abstract Background: Adjuvant endocrine therapy compromises bone health in patients (pts) with breast cancer, leading to osteopenia, osteoporosis, and fractures (Forbes 2008). For postmenopausal women with estrogen receptor (ER) positive (+ve) breast cancer, aromatase inhibitors (AI) have emerged as the standard of care because of superior efficacy over selective ER modulators such as tamoxifen, shown in several large clinical trials. As rates of utilization and duration of AI therapy are expected to continue to increase, we report estimates of the prevalence of women with nonmetastatic breast cancer treated with AI in the United States and examine evidence of bone loss before and after AI exposure. Methods: The Oncology Services Comprehensive Electronic Records (OSCER) database, an electronic medical record database on &amp;gt;500,000 cancer pts from oncology practices across the US, was used to identify women with breast cancer (ICD-9 174*), ≥1 clinic visit, and confirmed AI therapy (anastrozole, letrozole, or exemestane) in 2014, excluding pts with evidence of metastases (ICD-9 196-198, stage IV, or M1 disease). OSCER is projected nationally through methods of direct estimations utilizing claims data for 1-year period prevalence. Bone loss was defined by diagnosis of osteoporosis (ICD-9 733.0), osteopenia (ICD-9 733.90), or receipt of bone therapy in 2014. Bone therapies used as proxy for bone loss were intravenous (IV) (ibandronate, zoledronic acid), or oral bisphosphonates (BPs) (risedronate, ibandronate, etidronate, alendronate), or subcutaneous anti-RANK ligand antibody (denosumab [60 mg Q6M]). Results: It is nationally estimated that 538,630 (95% CI 519,839 - 557,422) women with nonmetastatic breast cancer were treated with an AI in 2014, representing a median of 6 prescriptions (mean 6.8). Of these, most (94%) were treated with anastrozole or letrozole, 55% were ≥65 years, and 11% took tamoxifen prior to first AI. Among women taking AI in 2014, 39% started in 2014, 24% started in 2013, and 37% have been on AI therapy since 2012 or earlier. Overall, 285,543 (53%) pts on AI therapy had evidence of bone loss, 30% of whom developed bone loss after exposure to AI therapy. Among the 338,784 women with no evidence of pre-existing bone loss, 25% (85,697) developed bone loss after initiating AI therapy (table), with 21% treated with oral and 1% IV BPs, or 9% with denosumab. 2014 prevalenceN (%)Nonmetastatic pts on AI therapy538,630At least 2 AI prescriptions in lifetime468,608 (87)Bone loss before starting AI199,846 (37)No bone loss before AI, with bone loss after AI85,697 (16) Conclusions: This study provides current estimates of the prevalence of nonmetastatic breast cancer treated with AI in the US using real-world data, indicating that more than 535,000 women were treated with AI in 2014. Considering that 37% of pts have been on endocrine therapy since 2012 or earlier, continued use of AI will likely lead to increased pts with bone loss. These women face an increased risk of fractures, highlighting the need for intervention with antiresorptive treatments (i.e., BPs have been studied, and denosumab has a labeled indication in this setting) that may help build bone mass and counteract detrimental effects on the bone. Citation Format: Pirolli M, Hernandez RK, Reich A, Liede A. Prevalence of bone loss among nonmetastatic breast cancer patients treated with aromatase inhibitors in the United States. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-12-03.

Ligustrum lucidum and its Constituents: A Mini-Review on the Anti-Osteoporosis Potential

Osteoporosis is a metabolic bone disorder commonly occurred in aging populations, particularly postmenopausal women and patients who undergo long-term steroid or anti-estrogen therapies. Given the rapid growth of the aging population, the prevalence of bone loss, and the huge medical and healthcare cost involved, demand for alternative approaches for the promotion of bone health is pressing. With the advent of global interest in complementary and alternative medicine and natural products, Chinese medicine serves as a viable source that offers benefits to improve and maintain bone health. This review summarizes the scientific information on the Chinese medicinal herb Ligustrum lucidum and its chemical components as potential therapy for osteoporosis.

A retrospective panoramic study for alveolar bone loss among young adults in Sulaimani City, Iraq

Objective: to determine the prevalence of alveolar bone crest loss among a selected sample of archival orthopantomography (OPG) in relation to number of sites affected and gender in Sulaimani City.&#x0D; Materials and Methods: A retrospective study was conducted with an inclusive period running from March to December 2007 to determine the prevalence of alveolar bone loss among 1072 subjects on panoramic radiographs. Panoramic images were sampled at the radiological archive of Dental School Hospital–University of Sulaimani for a selected age class ranged from 17 to 30 years. Bone loss was estimated by measuring the distance from cementoenamel junction (CEJ) minus 2 mm (physiologic high of interseptal alveolar crest) to the crest of the alveolar bone at sites with reduced normal level of interseptal bone. Total bone loss was divided into two groups according to number of sites affected; group one (1-3) sites showing bone loss per panoramic radiograph, and group 2 showing bone loss at more than 3 sites. Samples were also divided into two age groups; group one from 17 to 23 years and group two from 24 to 30 years. Moreover, bone loss was determined according to gender into male and female and number of sites affected for each gender. &#x0D; Results: results showed that 347 images – 30.2% of the total images showed bone loss at one site or more. 14.6% of the images revealed bone loss at 1-3 sites, whereas, 15.6% demonstrated bone loss at more than 3 sites. Percentage of bone loss was significantly higher (P=0.001) among group two (24-30 years old group) than group one (17-23 years old group) 38% against 25% respectively. Female’s radiographs recorded a non-significantly higher (P&gt;0.05) bone loss than male’s radiographs 31.7% against 28.7% respectively. &#x0D; Conclusion: prevalence of bone loss among young adults in Sulaimani City was relatively high compared to other published reports. There was a predilection for female. Bone loss was more prevalent at (24-30 years old group) compared to (17-23 years old group).

Prevalence and predictors of low bone density and fragility fractures in women with systemic lupus erythematosus in a Mediterranean region.

Studies have found an increase in bone loss and fracture in individuals with systemic lupus erythematosus (SLE) compared with general population. The aim of this study was to describe the prevalence of osteopenia, osteoporosis, and fragility fractures and to find potential predictors of bone loss in our cohort of SLE patients. We performed a cross-sectional study and collected 67 bone density measurements (BMD) of our SLE patients. We also collected sociodemographic data, 25-OH-vitamin D levels, serological markers, activity index, SLE cumulative damage index, and pharmacologic treatment. Sixty-seven consecutive BMD from SLE patients were assessed. Osteopenia was found in 28-46% of SLE patients. Osteoporosis ranged from 3 to 6%[corrected]. The only statistically significant correlation we found was between weight and height with total hip and femoral neck BMD (p < 0.05). The most frequent BMD-affected site was at the femoral neck, showing osteopenia in 40.3% [corrected] of SLE patients. Osteoporosis was found in up to 6% [corrected] of SLE patients. We found no predictors of bone loss in relation to the disease activity or its treatment. Fragility fractures were seen in 4.4% of SLE patients. All patients with fragility fractures showed osteopenia at BMD. There is a high prevalence of bone loss in SLE patients, since up to 40% [corrected] of SLE patients showed low BMD. Total hip and femoral neck osteopenia were the most frequent findings correlated with low BMI. We found a lower prevalence of fragility fractures compared with other series.

Residual periodontal pockets are a risk indicator for peri‐implantitis in patients treated for periodontitis

The aim of this retrospective study was to compare the clinical outcomes of implant treatment in periodontally compromised and periodontally healthy patients (PHP), with a minimum follow-up period of 5years. Thirty treated periodontally compromised patients (PCP) and 30 PHP, with a total of 117 Straumann implants (PCP=56, PHP=61) were matched for age, gender, smoking and implant characteristics. The PCP group was further stratified with patients having at least one periodontal pocket ≥6mm at follow-up examination allocated to a "residual periodontitis" (RP) group, while the remaining patients were assigned to a "no residual periodontitis" (NRP) group. These groups were compared with respect to probing pocket depth (PPD), bleeding on probing (BOP) and marginal bone loss. The mean follow-up period in the PCP and PHP groups was 7.99years (range 5.04-14.40) and 8.20years (range 5.00-13.46) respectively. There was no difference in mean PPD between the PCP and PHP groups, but the prevalence of implants with PPD ≥5mm+BOP was greater in the PCP group than in the PHP group, at both implant- (27% vs. 13%) and patient- (37% vs. 17%) level analyses. Mean implant PPD was significantly greater in the RP group (3.18mm) than in both the NRP (2.67mm) and PHP (2.81mm) groups. Mean bone loss was also significantly greater in the RP group (0.68mm) than in the NRP (0.23mm) and PHP groups (0.26mm). The prevalence of bone loss and PPD ≥5mm+BOP at the implant level was significantly greater for the RP group compared with both the NRP and PHP groups. Implants in PCP with residual pocketing at follow-up had increased PPD and bone loss compared with implants placed in PHP and PCP without residual pocketing. Hence, it is the maintenance of periodontal health rather than a previous history of periodontitis that is the critical determinant of increased risk of peri-implantitis, highlighting the importance of effective periodontal therapy and maintenance in patients with a history of periodontitis.

Prevalence of bone loss in a population with cystic fibrosis

The adverse effect of an increased life expectancy for people with cystic fibrosis (CF) is the increased risk of complications, such as CF-related low bone mineral density (BMD). Diagnosis of CF-related low BMD is confirmed by a dual-energy X-ray absorptiometry (DXA) scan. This study reports the results of an audit of DXA scans in 108 adults with CF in our clinic. The most common risk factors for bone loss were vitamin D deficiency (89%), CF-related diabetes (53%), low body mass index (39%) and post-lung transplant (25%); half of those with bone loss were genotype homozygous DF508. Overall fracture incidence was 5.5%; low BMD was not associated with high fracture rates. Thus BMD may not be a good predictor of fracture risk. Treatment includes bisphosphonates, which are difficult to take and have uncertain long-term effects. It is unknown whether bisphosphonate therapy is justified in this already overburdened group.

128: High prevalence of bone loss in long term survivors following allogeneic bone marrow and peripheral blood stem cell transplantation

128: High prevalence of bone loss in long term survivors following allogeneic bone marrow and peripheral blood stem cell transplantation

Risk of Cancer Treatment—Associated Bone Loss and Fractures Among Women with Breast Cancer Receiving Aromatase Inhibitors

Background Aromatase inhibitors (AIs) are a novel hormonal therapy for patients with breast cancer. However, AIs can cause bone loss by blocking estrogen production. This study aims to assess the association between AIs and treatment-related bone loss in a large managed-care population of women with breast cancer. Patients and Methods With use of medical and pharmacy claims, data from > 5 million beneficiaries between January 1, 1998, and January 31, 2005, we identified 12,368 patients with ≥ 2 breast cancer claims in a 6-month period who also had no bone metastases and no previous osteoporosis or fracture claims. Patients who had received antiestrogen (eg, tamoxifen) therapy were also excluded. One thousand three hundred fifty-four patients receiving an AI (anastrozole, exemestane, or letrozole) were compared with 11,014 controls who did not receive an AI with respect to their risk of bone loss. The observation start date for the AI and control groups was defined as the service date of the first AI claim and breast cancer claim, respectively. The endpoints include (1) bone loss, consisting of osteoporosis or osteopenia, and (2) clinical fractures. Results The univariate analysis found that the prevalence of bone loss was 8.7% in the AI group versus 7.1% in the control group, resulting in a significant relative risk of 1.3 (95% confidence interval [CI], 1.1-1.6; P = 0.01). The prevalence of bone fracture was also significantly increased in the AI group compared with the controls (13.5% vs. 10.3%) with a relative risk of 1.4 (95% CI, 1.2-1.6, P = 0.001). Multivariate Cox proportional hazards regressions showed that after adjusting for age and comorbidities, the risk of bone loss remained significantly higher in the AI group than in the non-AI group, with a 27% (95% CI, 4%-55%; P = 0.02) and 21% (95% CI, 3%-43%; P = 0.02) increase in the risk of bone loss and fractures, respectively. Conclusion This retrospective longitudinal analysis of a large cohort of patients with breast cancer corroborates previous findings from smaller clinical trials and demonstrates that AI therapies carry an increased risk of bone loss. Monitoring and treatment management strategies to reduce bone loss risk are warranted in women receiving an AI for breast cancer.

Radiographic study of the prevalence of periodontal bone loss in Australian school‐aged children attending the Royal Dental Hospital of Melbourne

To investigate the prevalence of alveolar bone loss around the first permanent molars, and first and second deciduous molars in Australian school-aged children attending the Royal Dental Hospital of Melbourne. Nine hundred and ninety-five records were examined for useable bitewing radiographs. From these, radiographs of 542 Australian school children aged 5-12 years were used. The cervical-enamel junction (CEJ) to the alveolar bone crest (ABC) distance was measured using the transparent ruler on the magnifier. Each inter-dental site that was readable was scored as one for the following categories: not available (NA); no bone loss (NBL)- the CEJ-ABC was < or =2 mm; questionable bone loss (QBL): the distance from the CEJ-ABC was >2 and <3 mm; and definite bone loss (DBL): the distance from the CEJ to ABC was > or =3 mm. Seventy-one children (13.0%) were found to have 83 DBL sites, as determined by bone levels >3.0 mm from the CEJ. Seventy children had QBL lesions only, 50 children had DBL only and 21 children had both. The overall prevalence of bone loss was 26%. Second deciduous molars were found to be the most affected teeth with almost 75% lesions being distal. These teeth comprised 50% of the DBL lesions. Children of Asian-Far Eastern origin had a higher percentage of sites with bone loss compared with children of Caucasian origin, being 29.5% and 19.7%, respectively, but lower than that of children of Middle-Eastern origin (35.2%). When the data were analysed with relation to age, there was no relationship between age and prevalence of bone loss. In the population studied, there was an overall prevalence of periodontal bone loss of 26% and DBL of 13% in an Australian school-aged group. Calculus was detected infrequently and, where present, was associated with bone loss.