Osteoporosis in dentistry

Osteoporosis is a phenomenon that has been demonstrated in various sites of the skeleton: radius, ulna, homers, femur, spine and jaw. Some bones with a large proportion of trabecular tissue are affected in greater quantity early compared to others, but in general the tendency towards bone loss in osteoporotic patients persists around the skeleton.

It has been suggested that there is a relationship between mandibular bone loss and osteopenia of the rest of the skeleton. Various investigations have reported that the loss of bone substance in the jaws is a reflection that the same is happening in other bones of the body.

This limits the possibility of an effective rehabilitation of the oral function. Likewise, the alveolar ridge constitutes a sensitive indicator of bone metabolism, noting the existence of systemic bone diseases in humans.

Oral disorders in osteoporotic patients

Reduction of the alveolar ridge: There are several etiological factors of a systemic or general type involved in alveolar bone loss, among which are nutrition, hormonal imbalance and postmenopausal osteoporosis. Several researchers have found a significant relationship between a deficient calcium intake, low calcium-phosphorus ratio of the diet and vitamin D deficiency with severe alveolar bone resumption. On the other hand it has been shown that the hormonal imbalance that affects postmenopausal women intensifies the resumption of the alveolar ridge. A large number of researches speak in favor of a positive correlation between the reabsorption of the alveolar ridge and the skeletal osteopenia,

Decrease in bone mass and maxillary bone density:  studies have shown that both bone mass and maxillary bone density are significantly higher in a healthy population than in an osteoporotic population. It has also been reported the existence of a positive correlation between the mineral density of edentulous jaws and the bone density of bones such as the radius and the homers.

Edentulous:  It has been determined that osteoporotic individuals have a greater loss of teeth than healthy ones. Comparative studies of bone mass conducted by Krebs (1990) show that 20% of osteoporotic individuals have edentulous compared to 7% of the normal group. Other studies corroborate the above, establishing that tooth loss in an osteoporotic group is 2, 4 times higher than in a healthy group. However, the loss of teeth due to systemic osteoporosis is difficult to demonstrate, since this loss can be due to a large number of factors such as endodontic problems, trauma, fractures and prosthetic problems.

Decrease in Cortical Bone Thickness:  Bras et al. (1982) indicate that there is an increase in cortical porosity of the jaw as age advances. Postmenopausal women show a thinning of the cortical angle of the mandible at the level of the onion. This is a measure of bone mass suggesting that generalized skeletal bone loss is occurring. We have tried to relate maxillary fractures with the increase in cortical porosity of the jaws of osteoporotic individuals.

Periodontal alterations: some studies did not find differences between the normal group and the osteoporotic group, in terms of periodontal measurements. These results suggest that Osteoporosis affects the maxillary bone and that periodontal alterations appear as local processes that are not influenced by skeletal bone diseases. However, it has been observed that those individuals with high skeletal mineral values, retain mostly their teeth and have a lower tendency to develop periodontal sacs compared to osteoporotic individuals. Then local factors can exert a greater effect on periodontal disease than systemic factors.