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Repercussions of osteoporosis on the maxillofacial complex: a critical overview

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Abstract

Introduction

We present here a literature review focusing on the repercussions of osteoporosis on the oral and maxillofacial complex. Osteoporosis is a silent metabolic disorder characterized by reduced bone mineral density (BMD), which can lead to bone fractures, particularly affecting elderly women. The prevalence of this disease has increased significantly worldwide, and since it accelerates bone resorption also in the jaw bones, some attention has been paid to possible oral and maxillofacial manifestations.

Materials and Methods

The databases PubMed and Google Scholar were searched for reports of oral and maxillofacial changes related to osteoporosis.

Results

Several parameters evaluating bone changes in panoramic radiography have been proposed to estimate osteoporosis-related BMD loss, but they tend to warn about the possibility of osteoporosis, rather than being diagnostic criteria. Meanwhile, it seems that osteoporosis-related BMD loss could delay alveolar bone healing and potentiate bone loss in periodontal disease.

Conclusion

Even though orofacial bones are not compromised by osteoporosis as much as the axial/appendicular skeleton, a regular dental follow-up of osteoporotic patients is advised, especially in the case of periodontal disease and maxillofacial surgery. Further controlled longitudinal studies considering the site-specificity of osteogenesis would be helpful regarding this issue.

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References

  1. Pavone V, Testa G, Giardina SMC, Vescio A, Restivo DA, Sessa G (2017) Pharmacological therapy of osteoporosis: a systematic current review of literature. Front Pharmacol 8:1–7

    Google Scholar 

  2. Liu J, Curtis EM, Cooper C, Harvey NC (2019) State of the art in osteoporosis risk assessment and treatment. J Endocrinol Invest 42:1149–1164

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Ono T, Hayashi M, Sasaki F, Nakashima T (2020) RANKL biology: Bone metabolism, the immune system, and beyond. Inflamm Regen 40:1–16

    Google Scholar 

  4. Cosman F, Crittenden DB, Adachi JD, Binkley N, Czerwinski E, Ferrari S, Hofbauer LC, Lau E, Lewiecki EM, Miyauchi A, Zerbini CAF, Milmont CE, Chen L, Maddox J, Meisner PD, Libanati C, Grauer A (2016) Romosozumab treatment in postmenopausal women with osteoporosis. N Engl J Med 375:1532–1543

    CAS  PubMed  Google Scholar 

  5. Laudisio A, Marzetti E, Antonica L, Settanni S, Georgakakis I, Bernabei R, Franceschi C, Zuccalà G (2007) Masticatory dysfunction is associated with osteoporosis in older men. J Clin Periodontol 34:964–968

    PubMed  Google Scholar 

  6. Passos J, Vianna M, Gomes-Filho I, Cruz SS, Barreto ML, Adan L, Rösing CK, Cerqueira EM, Trindade SC, Coelho JM (2013) Osteoporosis / osteopenia as an independent factor associated with periodontitis in postmenopausal women : a case – control study. Osteoporos Int 24:1275–1283

    CAS  PubMed  Google Scholar 

  7. Penoni DC, Torres SR, Farias MLF, Fernandes TM, Luiz RR, Leão AT (2016) Association of osteoporosis and bone medication with the periodontal condition in elderly women. Osteoporos Int 27:1887–1896

    CAS  PubMed  Google Scholar 

  8. Sachelarie L, Farcas DM, Dartu L, Vasiliu M, Daraba O, Nazarie S, Mocanu C, Burlui V (2016) Comparative study of diseases of the stomatognathic system and specific parameters of osteoporosis. Osteoporos Int 27:845–848

    CAS  PubMed  Google Scholar 

  9. Singhal S, Chand P, Singh BP, Singh SV, Rao J, Shankar R, Kumar S (2012) The effect of osteoporosis on residual ridge resorption and masticatory performance in denture wearers. Gerodontology 29:1059–1066

    Google Scholar 

  10. Kribbs PJ, Smith DE, Chesnut CH (1983) Oral findings in osteoporosis. Part II: relationship between residual ridge and alveolar bone resorption and generalized skeletal osteopenia. J Prosthet Dent 50:719–724

    CAS  PubMed  Google Scholar 

  11. Taguchi A, Fujiwara S, Masunari N, Suzuki G (2004) Self-reported number of remaining teeth is associated with bone mineral density of the femoral neck, but not of the spine, in Japanese men and women. Osteoporos Int 15:842–846

    PubMed  Google Scholar 

  12. Pan MY, Hsieh TC, Chen PH, Chen MY (2019) Factors associated with tooth loss in postmenopausal women: a community-based cross-sectional study. Int J Environ Res Public Health 16:1–8

    Google Scholar 

  13. Anwar RB, Tanaka M, Kohno S et al (2007) Relationship between porotic changes in alveolar bone and spinal osteoporosis. J Dent Res 86:52–57

    Google Scholar 

  14. Coutel X, Delattre J, Marchandise P, Falgayrac G, Béhal H, Kerckhofs G, Penel G, Olejnik C (2019) Mandibular bone is protected against microarchitectural alterations and bone marrow adipose conversion in ovariectomized rats. Bone 127:343–352

    PubMed  Google Scholar 

  15. Sundh V, Hange D, Ahlqwist M, Hakeberg M, Lissner L, Jonasson G (2017) FRAX and mandibular sparse trabeculation as fracture predictors: a longitudinal study from 1980 to 2002. Eur J Oral Sci 125:135–140

    PubMed  Google Scholar 

  16. Verheij JGC, Geraets WGM, Van Der Stelt PF, Horner K, Lindh C, Nicopoulou-Karayianni K, Jacobs R, Marjanovic EJ, Adams JE, Devlin H (2009) Prediction of osteoporosis with dental radiographs and age. Dentomaxillofacial Radiol 38:431–437

    CAS  Google Scholar 

  17. Bodade PR, Mody RN (2013) Panoramic radiography for screening postmenopausal osteoporosis in India: a pilot study. Oral Health Dent Manag 12:65–72

    PubMed  Google Scholar 

  18. Dagistan S, Bilge OM (2010) Comparison of antegonial index, mental index, panoramic mandibular index and mandibular cortical index values in the panoramic radiographs of normal males and male patients with osteoporosis. Dentomaxillofacial Radiol 39:290–294

    CAS  Google Scholar 

  19. Deguchi T, Yoshihara A, Hanada N, Miyazaki H (2008) Relationship between mandibular inferior cortex and general bone metabolism in older adults. Osteoporos Int 19:935–940

    CAS  PubMed  Google Scholar 

  20. Horner K, Devlin H (1998) The relationship between mandibular bone mineral density and panoramic radiographic measurements. J Dent 26:337–343

    CAS  PubMed  Google Scholar 

  21. Klemetti E, Kolmakow S (1997) Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofacial Radiol 26:22–25

    CAS  Google Scholar 

  22. Taguchi A, Sanada M, Krall E et al (2003) Relationship between dental panoramic radiographic findings and biochemical markers of bone turnover. J Bone Miner Res 18:1689–1694

    PubMed  Google Scholar 

  23. Taguchi A, Ohtsuka M, Tsuda M, Nakamoto T, Kodama I, Inagaki K, Noguchi T, Kudo Y, Suei Y, Tanimoto K (2007) Risk of vertebral osteoporosis in post-menopausal women with alterations of the mandible. Dentomaxillofacial Radiol 36:143–148

    CAS  Google Scholar 

  24. Devlin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P, Marjanovic E, Adams J, Pavitt S, Horner K (2007) Diagnosing osteoporosis by using dental panoramic radiographs: The OSTEODENT project. Oral Surg Oral Med Oral Pathol Radiol Endodontol 104:821–828

    Google Scholar 

  25. Kalinowski P, Różyło-Kalinowska I, Piskórz M, Bojakowska-Komsta U (2019) Correlations between periodontal disease, mandibular inferior cortex index and the osteoporotic fracture probability assessed by means of the fracture risk assessment body mass index tool. BMC Med Imaging 19:1–8

    Google Scholar 

  26. Munhoz L, Aoki EM, Cortes ARG, de Freitas CF, Arita ES (2018) Osteoporotic alterations in a group of different ethnicity Brazilian postmenopausal women: an observational study. Gerodontology 35:101–109

    PubMed  Google Scholar 

  27. Ledgerton D, Homer K, Devlin H, Worthington H (1999) Radiomorphometric indices of the mandible in a British female population. Dentomaxillofacial Radiol 28:173–181

    CAS  Google Scholar 

  28. Liu M, Kurimoto P, Zhang J, Stolina M, Dechow PC, Feng JQ, Hesterman J, Silva MD, Ominsky MS, Richards WG, Ke H, Kostenuik PJ (2018) Sclerostin and DKK1 inhibition preserves and augments alveolar bone volume and architecture in rats with alveolar bone loss. J Dent Res 97:1031–1038

    CAS  PubMed  Google Scholar 

  29. Jonasson G, Skoglund I, Rythén M (2018) The rise and fall of the alveolar process: dependency of teeth and metabolic aspects. Arch Oral Biol 96:195–200

    PubMed  Google Scholar 

  30. Chen CH, Wang L, Serdar Tulu U, Arioka M, Moghim MM, Salmon B, Chen CT, Hoffmann W, Gilgenbach J, Brunski JB, Helms JA (2018) An osteopenic/osteoporotic phenotype delays alveolar bone repair. Bone 112:212–219

    PubMed  Google Scholar 

  31. Luvizuto ER, Dias SMD, Queiroz TP, Okamoto T, Garcia IR Jr, Okamoto R, Dornelles RC (2010) Osteocalcin immunolabeling during the alveolar healing process in ovariectomized rats treated with estrogen or raloxifene. Bone 46:1021–1029

    CAS  PubMed  Google Scholar 

  32. Li Y, He S, Hua Y, Hu J (2017) Effect of osteoporosis on fixation of osseointegrated implants in rats. J Biomed Mater Res Part B Appl Biomater 105:2426–2432

    CAS  Google Scholar 

  33. de Medeiros FCFL, Kudo GAH, Leme BG, Saraiva PP, Verri FR, Honório HM, Pellizzer EP, Santiago Junior JF (2018) Dental implants in patients with osteoporosis: a systematic review with meta-analysis. Int J Oral Maxillofac Surg 47:480–491

    PubMed  Google Scholar 

  34. Temmerman A, Rasmusson L, Kübler A, Thor A, Merheb J, Quirynen M (2019) A prospective, controlled, multicenter study to evaluate the clinical outcome of implant treatment in women with osteoporosis/osteopenia: 5-year results. J Dent Res 98:84–90

    CAS  PubMed  Google Scholar 

  35. Jagur O, Kull M, Leibur E, Kallikorm R, Loorits D, Lember M, Voog-Oras U (2011) Relationship between radiographic changes in the temporomandibular joint and bone mineral density: a population based study. Stomatologija 13:42–48

    PubMed  Google Scholar 

  36. Bäck K, Ahlqwist M, Hakeberg M, Björkelund C, Dahlström L (2017) Relation between osteoporosis and radiographic and clinical signs of osteoarthritis/arthrosis in the temporomandibular joint: a population-based, cross-sectional study in an older Swedish population. Gerodontology 34:187–194

    PubMed  Google Scholar 

  37. Kosugi K, Yonezu H, Kawashima S, Honda K, Arai Y, Shibahara T (2013) A longitudinal study of the effect of experimental osteoporosis on bone trabecular structure in the rat mandibular condyle. Cranio J Craniomandib Pract 31:140–150

    Google Scholar 

  38. Payne JB, Reinhardt RA, Nummikoski PV, Patil KD (1999) Longitudinal alveolar bone loss in postmenopausal osteoporotic / osteopenic women. Osteoporos Int 10:34–40

    CAS  PubMed  Google Scholar 

  39. Penoni DC, Fidalgo TKS, Torres SR, Varela VM, Masterson D, Leão AT, Maia LC (2017) Bone density and clinical periodontal attachment in postmenopausal women: a systematic review and meta-analysis. J Dent Res 96:261–269

    CAS  PubMed  Google Scholar 

  40. Darcey J, Devlin H, Lai D, Walsh T, Southern H, Marjanovic E, Horner K (2013) An observational study to assess the association between osteoporosis and periodontal disease. Br Dent J 215:617–621

    CAS  PubMed  Google Scholar 

  41. Hernández-Vigueras S, Martínez-Garriga B, Sánchez MC, Sanz M, Estrugo-Devesa A, Vinuesa T, López-López J, Viñas M (2016) Oral Microbiota, periodontal status, and osteoporosis in postmenopausal females. J Periodontol 87:124–133

    PubMed  Google Scholar 

  42. Chaves JDP, Figueredo TFM, Warnavin SVSC, Pannuti CM, Steffens JP (2020) Sex hormone replacement therapy in periodontology—A systematic review. Oral Dis 26:270–284

    PubMed  Google Scholar 

  43. Ruggiero S, Dodson T, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O'Ryan F (2014) Medication-related osteonecrosis of the Jaw—2014 update. J Oral Maxillofac Surg 72:1938–1956

    PubMed  Google Scholar 

  44. Rebelo Pontes HA, de Souza LL, Colares Uchôa DC, Mendes Cerqueira JM (2018) Mandibular osteonecrosis associated with raloxifene. J Craniofac Surg 29:e257–e259

    Google Scholar 

  45. Miyauchi A, Dinavahi RV, Crittenden DB, Yang W, Maddox JC, Hamaya E, Nakamura Y, Libanati C, Grauer A, Shimauchi J (2019) Increased bone mineral density for 1 year of romosozumab, vs placebo, followed by 2 years of denosumab in the Japanese subgroup of the pivotal FRAME trial and extension. Arch Osteoporos 14:1–13

    Google Scholar 

  46. Akintoye SO, Lam T, Shi S, Collins MT, Robey PG (2006) Skeletal site-specific characterization of orofacial and iliac crest human bone marrow stromal cells in same individuals. Bone 38:758–768

    CAS  PubMed  Google Scholar 

  47. Du Y, Jiang F, Liang Y, Wang Y, Zhou W, Pan Y, Xue M, Peng Y, Yuan H, Chen N, Jiang H (2016) The angiogenic variation of skeletal site-specific human BMSCs from same alveolar cleft patients: a comparative study. J Mol Histol 47:153–168

    PubMed  Google Scholar 

  48. Osyczka AM, Damek-Poprawa M, Wojtowicz A, Akintoye SO (2009) Age and skeletal sites affect BMP-2 responsiveness of human bone marrow stromal cells. Connect Tissue Res 50:270–277

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Tobeiha M, Moghadasian MH, Amin N, Jafarnejad S (2020) RANKL/RANK/OPG pathway: a mechanism involved in exercise-induced bone remodeling. Biomed Res Int 30:457–465

    Google Scholar 

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Acknowledgements

We thank Dr A. Leyva (USA) for English editing of the manuscript. We also thank CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico) for the support received.

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Authors and Affiliations

  1. School of Health and Life Sciences, Serviço de Estomatologia – Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-001, Brazil

    Valesca Sander Koth, Fernanda Gonçalves Salum, Maria Antonia Zancanaro de Figueiredo & Karen Cherubini

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  1. Valesca Sander Koth
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  2. Fernanda Gonçalves Salum
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  3. Maria Antonia Zancanaro de Figueiredo
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All authors contributed to the idea and design of the study. Literature search and analysis were performed by VSK and KC. The first draft of the manuscript was written by VSK and KC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Valesca Sander Koth.

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Koth, V.S., Salum, F.G., de Figueiredo, M.A.Z. et al. Repercussions of osteoporosis on the maxillofacial complex: a critical overview. J Bone Miner Metab 39, 117–125 (2021). https://doi.org/10.1007/s00774-020-01156-4

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