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Decayed, Missing, and Filled Teeth Index and Periodontal Health in Osteoporotic Patients Affected by BRONJ: An Observational Study

DOI: 10.1155/2013/231289

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The aim of this paper is to describe the incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease in 32 osteoporotic patients affected by bisphosphonate-related osteonecrosis of the jaw (BRONJ). Moreover, an investigation between the obtained data and 20 patients treated with bisphosphonate drugs and with no evidence of ONJ has been performed. Osteonecrosis of the jaws is a rare complication in a subset of patients receiving bisphosphonate drugs. Based on a growing number of case reports and institutional reviews, this kind of therapy can cause exposed and necrotic bone specifically in the jawbones. From April 2009 to June 2012, 32 osteoporotic patients treated with oral or intravenous (I.V.) bisphosphonates have been recorded. The patients’ oral health has been compared with 20 bisphosphonates patients with no ONJ. The incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease was recorded in all patients and student’s -test was applied for comparing the two investigated groups data. Data demonstrated how the poor dental hygiene and periodontal disease of the BRONJ patients’ are connected with the occurrence of jawbone necrosis. 1. Introduction Osteoporosis is a systemic skeletal disorder characterized by skeletal fragility, microarchitectural variation, and low bone mineral density estimated with a T-score for bone mineral density below ?2.5 (National Institutes of Health Consensus Conference) [1]. Osteoporosis is one of the most common chronic diseases referred in 1/3 postmenopausal women and 1/5, men over the age of 50 years (European Parliament Osteoporosis Interest Group and EU Osteoporosis Consultation Panel 2004) [2]. Although it is widely recognized that low bone mass is not the only determinant of bone fragility, the strength of the skeleton is influenced by other bone tissue properties, collectively named “bone quality” [3, 4]. Change of bone remodelling pattern in osteoporosis patients resulted in perforation of trabecular plates and loss of cancellous trabecular elements with consequent bone mineral density reduction. Bisphosphonates are a new class of drugs indicated for use in patients with osteoporosis, Paget’s disease of bone, hypercalcemia in a malignant disease, osteolytic bone metastases, and osteolytic lesions of multiple myeloma. Despite the benefits of bisphosphonate therapy like increasing bone density and preventing bone pathological fractures, osteonecrosis of the jaw is a rare complication in a subset of patients receiving these drugs. This complication often occurs after simple

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