Periodontal disease defects and mandibular cortical index in lupus patients

Objective:Systemic lupus erythematosus is an autoimmune disease that affects multiple organs. It is well known that lupus patients have higher risk of osteoporosis, but if the disease affects mandibular cortical bone and alveolar bone is not fully established. The objective of this study was to evaluate periodontal disease defects and mandibular osteoporotic alterations in patients with lupus as compared to healthy patients using panoramic radiographs.Material and Methods:The panoramic radiographs of 72 patients with lupus and 360 healthy patients were evaluated for the presence of bone loss secondary to periodontal disease, classified as horizontal and vertical bone loss. We also assessed mandibular osteoporotic alterations by using the mandibular cortical index. Logistic regression analysis was applied to estimate the risk of mandibular osteoporotic alterations as well as horizontal and vertical bone loss in patients with lupus as compared to healthy patients.Results:There were no statistically significant differences between groups in the presence of horizontal bone defects and mandibular cortical indexes. However, patients with lupus demonstrated that patients with lupus were 2.17 more likely to present vertical bone loss than healthy patients.Conclusions:Patients with lupus might have higher risk of vertical bone loss than healthy patients due to pathophysiology of their disease. Further larger prospective studies should be performed to confirm our findings.

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Does type 2 diabetic osteoporotic patients present more periodontal risks than non-osteoporotic patients? An evaluation with mandibular cortical index (Klemetti)

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v17i0.8654217 ◽

2018 ◽

Vol 17 ◽

pp. e181211

Author(s):

Wladimir Gushiken de Campos ◽

Gonzalo André Montesinos ◽

Rosa Cristina Peinado Agudo ◽

Kaisermann Costa ◽

Luciana Munhoz ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bone Loss ◽

Periodontal Disease ◽

Diabetic Patients ◽

Mineral Density ◽

Cortical Index ◽

Increased Risk ◽

Type 2 Diabetic ◽

Mandibular Cortical Index

Aim: This study aim was to evaluate if patients with type 2 diabetes and osteoporosis have an increased risk of periodontal disease (horizontal and vertical bone loss) when compared to diabetic patients without osteoporosis. Additionally, to assess if patients with diabetes and osteoporosis have a greater risk of reduction of bone mineral density in the mandible, expressed by mandibular cortical index (MCI) when compared to diabetic patients without osteoporosis. Methods: 59 patients (39 diagnosed with type 2 diabetes and osteoporosis; 20 diagnosed with type 2 diabetes and without osteoporosis) were selected. Type 2 diabetes was previously diagnosed by glycated hemoglobin examination and osteoporosis by peripheral dual-energy x-ray absorptiometry. Mandibular cortical index, as well as the presence of vertical and horizontal bone loss was verified on panoramic radiographs. Adjusted odds ratio analyses were performed on presence of periodontal disease and MCI considering the effect of osteoporosis. Results: Absence of statistical significance between variables was found. Conclusions: There is no difference between the risk of periodontal disease or low MCI among osteoporotic and non-osteoporotic type 2 diabetic patients.

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Panoramic radiographs for detecting osteopenia: A pilot study

Clinics and Practice ◽

10.4081/cp.2017.973 ◽

2017 ◽

Vol 7 (4) ◽

Author(s):

Vivek Velayudhan Nair ◽

Sunila Thomas ◽

Jincy Thomas ◽

Cucoo Mariam Mathew

Keyword(s):

Pilot Study ◽

Bone Mass ◽

Gold Standard ◽

Age Group ◽

Low Bone Mass ◽

Panoramic Radiographs ◽

Cortical Index ◽

Mandibular Cortical Index

Osteoporosis characterized by low bone mass/osteopenia can be identified using radiomorphometric indices in routine panoramic radiographs. This study estimates the prevalence of osteopenia in 50-80 years age group, using panoramic mandibular index (PMI), mental index (MI) and mandibular cortical index (MCI). PMI, MI and MCI were applied on 36 panoramic radiographs; MI and MCI were compared with PMI. The prevalence of osteopenia was 11.1% with PMI and 44.4% with MCI. Using MI, the prevalence was 2.8% and 33.3% with 3mm and 4.77mm threshold respectively. The prevalence of osteopenia detected was highest using MCI (44.4%). Considering PMI as gold standard, MI with 4.77 mm threshold showed better agreement with PMI.

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Telmisartan Prevents Alveolar Bone Loss by Decreasing the Expression of Osteoclasts Markers in Hypertensive Rats With Periodontal Disease

Frontiers in Pharmacology ◽

10.3389/fphar.2020.579926 ◽

2020 ◽

Vol 11 ◽

Author(s):

Victor Gustavo Balera Brito ◽

Mariana Sousa Patrocinio ◽

Maria Carolina Linjardi de Sousa ◽

Ayná Emanuelli Alves Barreto ◽

Sabrina Cruz Tfaile Frasnelli ◽

...

Keyword(s):

Angiotensin Ii ◽

Bone Loss ◽

Bone Formation ◽

Periodontal Disease ◽

Alveolar Bone ◽

Renin Angiotensin System ◽

Alveolar Bone Loss ◽

Hypertensive Rats ◽

Bone Formation Markers ◽

Tnf Α

Periodontal disease (PD) is a prevalent inflammatory disease with the most severe consequence being the loss of the alveolar bone and teeth. We therefore aimed to evaluate the effects of telmisartan (TELM), an angiotensin II type 1 receptor (Agtr1) antagonist, on the PD-induced alveolar bone loss, in Wistar (W) and Spontaneous Hypertensive Rats (SHRs). PD was induced by ligating the lower first molars with silk, and 10 mg/kg TELM was concomitantly administered for 15 days. The hemimandibles were subjected to microtomography, ELISA was used for detecting tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), CXCL3, and CCL2, while qRT-PCR was used for analyzing expression of components of renin-angiotensin system (RAS) (Agt, Ace, Agt1r, Agt2r, Ace2, and Masr), and bone markers (Runx2, Osx, Catnb, Alp, Col1a1, Opn, Ocn, Bsp, Bmp2, Trap, Rank, Rankl, CtsK, Mmp-2, Mmp-9, and osteoclast-associated receptor (Oscar)). The SHR + PD group showed greater alveolar bone loss than the W + PD group, what was significantly inhibited by treatment with TELM, especially in the SHR group. Additionally, TELM reduced the production of TNF-α, IL-1β, and CXCL3 in the SHR group. The expression of Agt increased in the groups with PD, while Agtr2 reduced, and TELM reduced the expression of Agtr1 and increased the expression of Agtr2, in W and SHRs. PD did not induce major changes in the expression of bone formation markers, except for the expression of Alp, which decreased in the PD groups. The bone resorption markers expression, Mmp9, Ctsk, and Vtn, was higher in the SHR + PD group, compared to the respective control and W + PD group. However, TELM attenuated these changes and increased the expression of Runx2 and Alp. Our study suggested that TELM has a protective effect on the progression of PD, especially in hypertensive animals, as evaluated by the resorption of the lower alveolar bone. This can be partly explained by the modulation in the expression of Angiotensin II receptors (AT1R and AT2R), reduced production of inflammatory mediators, the reduced expression of resorption markers, and the increased expression of the bone formation markers.

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Coated vs Uncoated Implants: Bone Defect Configurations After Progressive Peri-implantitis in Dogs

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-12-00089 ◽

2014 ◽

Vol 40 (6) ◽

pp. 661-669 ◽

Cited By ~ 9

Author(s):

Marwa Madi ◽

Osama Zakaria ◽

Shohei Kasugai

Keyword(s):

Bone Loss ◽

Bone Defect ◽

Alveolar Bone ◽

Bone Defects ◽

Class Ii ◽

Alveolar Bone Loss ◽

Class I ◽

Class Iii ◽

Implant Surface ◽

Plasma Sprayed

In this study, hydroxyapatite coated vs uncoated implants were used to evaluate the type and dimensions of bone defects after progressive peri-implantitis in dogs. Thirty-two dental implants with 4 different surfaces—machined (M), sandblasted acid-etched (SA), 1-μm thin sputter hydroxyapatite (HA)-coated (S), and plasma-sprayed HA-coated (P)—were inserted into the mandibles of 4 beagle dogs after extracting all mandibular premolars. Experimental peri-implantitis was induced after 3 months using ligature to allow for plaque accumulation. After 4 months, ligatures were removed and plaque accumulation continued for 5 months (progression period). The open flap surgery demonstrated 3 patterns of peri-implantitis bone defect: (1) Class I defect: represented as circumferential intra-alveolar bone loss; (2) Class II defect: circumferential intra-alveolar defect with supra-alveolar bone loss exposing the implant surface; and (3) Class III defect: represented as circumferential intra-alveolar defect with supra-alveolar bone loss and buccal dehiscence. Class I was the most frequent (62.5%) defect pattern around implant types M, SA, and S; while implant type-P showed a recurring majority of Class II (62.5%). Comparison among the 4 implant groups revealed a significant defect width (DW) in implant type-P relative to other types (P < 0.01). However, no statistically significant differences were noted for defect depth (DD) (P > 0.05). We concluded that the shape and size of peri-implantitis bone defects were influenced by the type and thickness of the HA coat together with the quantity of the available peri-implant bone. Plasma-sprayed HA-coated implants showed larger peri-implant defects than did thin sputter HA-coated implants.

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Are Panoramic Radiographs Reliable to Diagnose Mild Alveolar Bone Resorption?

ISRN Dentistry ◽

10.5402/2011/363578 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Larissa Semenoff ◽

Tereza Aparecida Delle Semenoff ◽

Fabio Luiz Miranda Pedro ◽

Evaristo Ricci Volpato ◽

Maria Aparecida de Andrade Moreira Machado ◽

...

Keyword(s):

Bone Resorption ◽

Bone Loss ◽

Alveolar Bone ◽

Treatment Plan ◽

Dental Practice ◽

Research Protocol ◽

Inclusion Criteria ◽

Panoramic Radiographs ◽

Significant Difference ◽

Minimum Distortion

It is extremely important to assess variations between the most used radiographs in dental practice, since minimum distortion on obtained images may change diagnosis, treatment plan, and prognosis for the patient. For this, the distance between the enamel-cementum junction and the alveolar bone crest was measured on conventional and digitized periapical, bitewing, and panoramic radiographs and compared among them. From a total of 1484 records, 39 sets of radiographs that fulfilled the inclusion criteria of the study sample were selected. The measurements were grouped according to the intensity of bone loss. Statistically significant difference was found in the averages of the measurements assessed in radiographs with absence of bone loss between conventional panoramic and periapical radiographs, between digitized panoramic and periapical radiographs and between digitized bitewing and panoramic radiographs. By analyzing the results of this work and considering the research protocol used, one can conclude that small losses in height of alveolar bone crest observed in panoramic radiographs should be cautiously evaluated, as they may be overestimated.

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