title: Comparative study of axial and femoral bone mineral density and parameters of mandibular bone quality in patients receiving dental implants.
abstract: BACKGROUND
  In view of the increase in the life expectancy of humans and in edentulism of the population above 50 years of age, in which the prevalence of osteoporosis is also higher, it is fundamental to better understand the effects of systemic bone mass loss on the healing process of dental implants and to determine the quality of the bone that surrounds them. The objective of the present study was to compare systemic osteoporosis (axial and femoral) and parameters of mandibular bone quality, and to evaluate osseointegration in postmenopausal women receiving dental implants.
  
  
  METHODS
  The sample consisted of 39 women aged 48-70 years, 19 with a densitometric diagnosis of osteoporosis in the lumbar spine and femoral neck and 20 controls with a normal densitometric diagnosis. Bone mineral density was measured in the patients and controls by dual-energy X-ray absorptiometry. Eighty-two osseointegrated dental implants were placed in the mandible, 39 of them in the osteoporosis group and 43 in the control group. Mandibular bone quality was evaluated by classifying mandibular inferior cortical and trabecular bone on panoramic radiographs and by histomorphometric analysis of a mandibular bone biopsy. Osseointegration was analyzed after 9 months.
  
  
  RESULTS
  No significant difference was observed between patients with osteoporosis and controls when comparing individuals with a normal cortex and those with a severely or moderately eroded cortex determined on panoramic radiographs, although patients with MEC/SEC had lower femoral neck BMD than those with NC (0.688 +/- 0.17 vs. 0.814+/- 0.144 g/cm2, P<0.012). Histomorphometric analysis also revealed no difference in the parameters of bone formation or resorption between the two groups. Implant failure was observed in only one case.
  
  
  CONCLUSIONS
  We conclude that there is an association between low femoral neck BMD and poor mandibular bone quality as assessed by panoramic radiography. The loss of one implant (1.2%) is compatible with the literature and cannot be attributed to systemic osteoporosis.
authors.affiliation: Division of Rheumatology, Bone Mineral Metabolism Laboratory, University of São Paulo, São Paulo, Brazil.
authors.forename: M A L
authors.initials: MA
authors.lastname: Amorim
authors.forename: L
authors.initials: L
authors.lastname: Takayama
authors.forename: V
authors.initials: V
authors.lastname: Jorgetti
authors.forename: R M R
authors.initials: RM
authors.lastname: Pereira
mesh_terms: D000368:Aged; D015519:Bone Density / Q000502:physiology*; D015921:Dental Implants; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008334:Mandible / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011475:Prosthesis Failure; D011859:Radiography
chemical_list: D015921:Dental Implants