TRABECULAR BONE SCORE AND DENTAL IMPLANT
The article brings in the same plan and unified views related to two different phenomena: dental implant (DI) and osteoporosis. 1. DI and osteoporosis. Successful DI depends on bone quality. One of the relative contraindications of DI is osteoporosis. However, there are studies showing that DI ca...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2018-09-01
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| Series: | Romanian Medical Journal |
| Subjects: | |
| Online Access: | https://revistemedicale.amaltea.ro/Romanian_MEDICAL_Journal/Revista_MEDICALA_ROMANA-2018-Nr.3/RMJ_2018_3_Art-03.pdf |
| _version_ | 1797333781869232128 |
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| author | Dan Pereţianu Adrian Sîrbu Denis Păduraru Dana Cristina Staicu Aurelian Ranetti |
| author_facet | Dan Pereţianu Adrian Sîrbu Denis Păduraru Dana Cristina Staicu Aurelian Ranetti |
| author_sort | Dan Pereţianu |
| collection | DOAJ |
| description | The article brings in the same plan and unified views related to two different phenomena: dental implant (DI) and
osteoporosis.
1. DI and osteoporosis. Successful DI depends on bone quality. One of the relative contraindications of DI is
osteoporosis. However, there are studies showing that DI can be done in patients with osteoporosis. In cases of
osteoporosis, success depends on the lack of previous antiosteoporotic bisphosphonate treatments.
2, Diagnosis of osteoporosis. It is based on the T-score obtained for Bone Mineral Density (BMD) in DEXA (dual
X ray absortiometry) tests; they must be < -2.5. This value is the standard deviation applied to an average obtained
from adults. What happens to bone quality in patients with possibly osteoporosis but with BMD > -2.5? The
problem of diagnosis can be solved by a new DEXA technique: trabecular bone score.3. Trabecular bone score (TBS) is the mathematical estimation of vertebral microarhitectomy.The vertebra are
formed by trabecular bone (the long bone is predominantly the cortical bone). TBS is obtained by DEXA analysis
with specific software. A value < -2.5 means osteoporosis. Our data showed that through TBS analysis the
prevalence of osteoporosis diagnosis increased by about 40% in patients who have BMD within the limits
considered by osteopenia or normal.
4. Relationship between mandible/maxillary and trabecular bone. Mandible and the maxillary are mixed bones. At
the surface it presents as a cortical bone, in depth, it presents with trabecular bone structure. The cortical bone
(both of mandible & maxillary) is defined as that white structure without a trabecular pattern. The trabecular bone
is that part of the mandible that is found between two cortical plates. It is appropriate to make an implant when the
cortical bone is more abundant. It is also stated that the implants performed in over 60% trabecular (cancellous)
bone are more efficient than those performed in less than 30% of the trabecular bone. The phenomenon arises
from the fact that the trabecular bone is more metabolically active and contains more osteoblasts. TBS obtained
by DEXA for the vertebrae can be surrogate for the assessment of the trabecular bone in the mandible and
maxillary.
5. Drugs that improve the trabecular bone score. Following the re-analysis of the TBS-BMD difference by the TBS
technique, the perception of antiosteoporotic drugs has changed. More important is to improve TBS than increase
BMD. Thus, teriparatide, then denosumab, strontium, SERM, and lastly bisphosphonates would be preferentially
used. Furthermore, teriparatide was the only treatment available for post-bisphosphonates jaw necrosis. |
| first_indexed | 2024-03-08T08:10:04Z |
| format | Article |
| id | doaj.art-fb6dc2951534476e9b7adbf97abf15c6 |
| institution | Directory Open Access Journal |
| issn | 1220-5478 2069-606X |
| language | English |
| last_indexed | 2024-03-08T08:10:04Z |
| publishDate | 2018-09-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Medical Journal |
| spelling | doaj.art-fb6dc2951534476e9b7adbf97abf15c62024-02-02T09:41:22ZengAmaltea Medical Publishing HouseRomanian Medical Journal1220-54782069-606X2018-09-0165316917610.37897/RMJ.2018.3.3TRABECULAR BONE SCORE AND DENTAL IMPLANTDan Pereţianu0Adrian Sîrbu1Denis Păduraru2Dana Cristina Staicu3Aurelian Ranetti4SCM „Povernei“, BucureştiCM „Sana“, BucureştiInstitutul Naţional de Medicină Sportivă, BucureştiSCM „Povernei“, BucureştiDepartamentul de Endocrinologie, Spitalul Militar Central, BucureştiThe article brings in the same plan and unified views related to two different phenomena: dental implant (DI) and osteoporosis. 1. DI and osteoporosis. Successful DI depends on bone quality. One of the relative contraindications of DI is osteoporosis. However, there are studies showing that DI can be done in patients with osteoporosis. In cases of osteoporosis, success depends on the lack of previous antiosteoporotic bisphosphonate treatments. 2, Diagnosis of osteoporosis. It is based on the T-score obtained for Bone Mineral Density (BMD) in DEXA (dual X ray absortiometry) tests; they must be < -2.5. This value is the standard deviation applied to an average obtained from adults. What happens to bone quality in patients with possibly osteoporosis but with BMD > -2.5? The problem of diagnosis can be solved by a new DEXA technique: trabecular bone score.3. Trabecular bone score (TBS) is the mathematical estimation of vertebral microarhitectomy.The vertebra are formed by trabecular bone (the long bone is predominantly the cortical bone). TBS is obtained by DEXA analysis with specific software. A value < -2.5 means osteoporosis. Our data showed that through TBS analysis the prevalence of osteoporosis diagnosis increased by about 40% in patients who have BMD within the limits considered by osteopenia or normal. 4. Relationship between mandible/maxillary and trabecular bone. Mandible and the maxillary are mixed bones. At the surface it presents as a cortical bone, in depth, it presents with trabecular bone structure. The cortical bone (both of mandible & maxillary) is defined as that white structure without a trabecular pattern. The trabecular bone is that part of the mandible that is found between two cortical plates. It is appropriate to make an implant when the cortical bone is more abundant. It is also stated that the implants performed in over 60% trabecular (cancellous) bone are more efficient than those performed in less than 30% of the trabecular bone. The phenomenon arises from the fact that the trabecular bone is more metabolically active and contains more osteoblasts. TBS obtained by DEXA for the vertebrae can be surrogate for the assessment of the trabecular bone in the mandible and maxillary. 5. Drugs that improve the trabecular bone score. Following the re-analysis of the TBS-BMD difference by the TBS technique, the perception of antiosteoporotic drugs has changed. More important is to improve TBS than increase BMD. Thus, teriparatide, then denosumab, strontium, SERM, and lastly bisphosphonates would be preferentially used. Furthermore, teriparatide was the only treatment available for post-bisphosphonates jaw necrosis.https://revistemedicale.amaltea.ro/Romanian_MEDICAL_Journal/Revista_MEDICALA_ROMANA-2018-Nr.3/RMJ_2018_3_Art-03.pdfmaxillarymandibletrabecular bonedental implantosteoporosis |
| spellingShingle | Dan Pereţianu Adrian Sîrbu Denis Păduraru Dana Cristina Staicu Aurelian Ranetti TRABECULAR BONE SCORE AND DENTAL IMPLANT Romanian Medical Journal maxillary mandible trabecular bone dental implant osteoporosis |
| title | TRABECULAR BONE SCORE AND DENTAL IMPLANT |
| title_full | TRABECULAR BONE SCORE AND DENTAL IMPLANT |
| title_fullStr | TRABECULAR BONE SCORE AND DENTAL IMPLANT |
| title_full_unstemmed | TRABECULAR BONE SCORE AND DENTAL IMPLANT |
| title_short | TRABECULAR BONE SCORE AND DENTAL IMPLANT |
| title_sort | trabecular bone score and dental implant |
| topic | maxillary mandible trabecular bone dental implant osteoporosis |
| url | https://revistemedicale.amaltea.ro/Romanian_MEDICAL_Journal/Revista_MEDICALA_ROMANA-2018-Nr.3/RMJ_2018_3_Art-03.pdf |
| work_keys_str_mv | AT danperetianu trabecularbonescoreanddentalimplant AT adriansirbu trabecularbonescoreanddentalimplant AT denispaduraru trabecularbonescoreanddentalimplant AT danacristinastaicu trabecularbonescoreanddentalimplant AT aurelianranetti trabecularbonescoreanddentalimplant |