Evaluation of Effect of Bisphosphonates on Dental Implant Therapy in Postmenopausal Women Using Cone Beam Computed Tomography.

AIM: Osteoporosis is one of the diseases which show significant bone mass reduction especially in post menopausal women. The present study was conducted to determine the effect of Bisphosphonates (BP) on alveolar bone and dental implant therapy in women after menopause. MATERIALS AND METHODS: The present study was conducted on 30 postmenopausal women who received at least one dental implant in the last 5 years. Group I comprised of 15 patients who were on BP therapy for 1.5 years, and group II consisted of 15 patients who were on parathyroid hormone (PTH). Bone mineral density (BMD) and bone thickness were assessed in both groups. RESULTS: Group I had 3.85% and group II had 3.15% of dental implants failures. BMD of cortical bone was 1552± 145 mg/mL and 1012 ± 94 mg/mL in groups I and II respectively. BMD of cancellous bone was 80 ± 15 mg/mL and 104 ± 72 mg/mL in group I and group II respectively. The difference was significant (p < 0.05). Cortical bone thickness was 2.5 ± 0.6 mm in group I and 2.2 ± 0.8 mm in group II. The difference was non-significant (p >0.05). There was a reduction in BMD (mg/mL) of cortical and cancellous bone. There was an increase in cortical bone thickness with the use of BPs over the years. The difference was significant (p < 0.05). CONCLUSION: There was a decrease in bone mineral density of both cortical and cancellous bone in both groups. There was increase cortical bone thickness on prolonging use of BPs. CLINICAL SIGNIFICANCE: Patients on BPs therapy should be carefully evaluated both clinically and radiographically before dental implant treatment as these agents affect the quantity and quality of cortical bone especially in the posterior mandibular region in patients with osteoporosis.

Correlates of Biochemical Markers of Bone turnover among Post-Menopausal Women.

INTRODUCTION: Bone turnover leading to osteoporosis and poor quality of life is common during post-menopausal period. Study of bone turnover markers that contribute to non-invasive assessment of bone-metabolic disorders holds an important area of research in low income country like Nepal. This study aimed to examine the correlates of bone turnover markers in post-menopausal women in tertiary level of health care center of Nepal. METHODS: A hospital-based cross-sectional study conducted during the period of November 2016 to December 2017 among 354 women. Blood samples for calcium, inorganic phosphorus, alkaline phosphatase and vitamin D were collected and analyzed using a validated and calibrated tools. Data were analyzed using Statistical Package for the Social Sciences software version 20. RESULTS: Mean±Standard deviation of age of post-menopausal women was significantly higher compared to pre-menopausal women (post-menopausal women, (57.98±8.08) vs. pre-menopausal, (31.35±5.83), (P<0.001). Selected biochemical markers of bone-turnover such as alkaline phosphatase levels were significantly higher with year since menopause (P<0.001), whereas serum calcium, and vitamin D were decreasing with year since menopause among post-menopausal women. In addition, calcium and vitamin D were significantly negatively correlated with year since menopause (P<0.01) while body mass index, inorganic phosphorus and alkaline phosphatase were significantly positively correlated with year since menopause (P<0.01). CONCLUSIONS: Our study revealed that body mass index, inorganic phosphorus and alkaline phosphatase positively correlated with year since menopause while calcium and vitamin D were negatively correlated suggesting for a medical supervision of hormonal changes and periodic dosing of calcium and vitamin D among post-menopausal women to reduce the problem of bone health.

Relación entre obesidad y osteoporosis, en mujeres posmenopáusicas del Hospital Nacional Arzobispo Loayza / Relationship between obesity and osteoporosis in postmenopausal women at the Arzobispo Loayza National Hospital

Introducción: la osteoporosis es una de las enfermedades óseas metabólicas más prevalentes; su curso es crónico y conlleva a una significante morbimortalidad en pacientes de la tercera edad. Esta enfermedad se ve alterada por múltiples factores, siendo uno de ellos la obesidad, la cual, debido a su carácter epidémico, se vislumbra como un factor protector importante. Objetivos: estudios previos, realizados en países desarrollados, demuestran que la obesidad es un factor protector para la osteoporosis; sin embargo, no hay un trabajo específico, que demuestre dicha hipótesis, en mujeres peruanas. El presente trabajo pretende determinar la relación existente entre obesidad y osteoporosis, en mujeres posmenopáusicas que acudieron al Servicio de Reumatología del Hospital Nacional Arzobispo Loayza (Lima, Perú) entre 1997 y el 2000. Material y métodos: el diseño empleado fue un estudio pareado de tipo caso y control, con muestreo incidental por saturación. Los casos fueron aquellas pacientes con diagnóstico de osteoporosis por densitometría de columna lumbar, realizada por un aparato de absorciometría de rayos X de doble fotón (DEXA). Los controles fueron pacientes equiparables en edad, tiempo de menopausia y número de hijos; sin dicho diagnóstico. Resultados: 1 738 pacientes cumplieron con los criterios de selección, con ellas se formaron 227 parejas de casos y controles con apareamiento perfecto. La frecuencia de obesidad en el grupo control fue de 27,8% y en el grupo de casos fue de 20,7%. Se obtuvo un odds ratio de 0,67, con un intervalo de confianza del 95% de 0,4241,07 (valor p = 0,098). Conclusiones: el presente estudio no demostró una relación estadísticamente significativa entre la obesidad y la osteoporosis. Sin embargo, parece existir un efecto protector entre dichas variables, el cual debe seguirse investigando.

Introduction: osteoporosis is one of the most prevalent metabolic bone diseases; it is chronic in evolution and produces significant morbidity and mortality in the elderly. This disease is altered by multiple factors; one of them is obesity, which seems to act as a protecting factor and, due to its epidemic nature, may be important. Objectives: previous research in developed countries has shown obesity to be a protective factor against osteoporosis, but there is no current specific investigation addressing this possibility in Peruvian women. This study seeks to explore this relationship in postmenopausal women who attended the rheumatology service of the Arzobispo Loayza National Hospital (Lima, Perú) between 1997 and 2000. Material and methods: the design used was a paired case and control study, with incidentall sampling to saturation. Cases were defined as patients with a clear diagnosis of osteoporosis by lumbar spine densitometry,carried out with the DEXA technique. Controls were patients equivalent in age, time of menopause and number of children, who were not osteoporotic. Results: 1 738 patients met selection criteria; 227 case and control pairs were formed, with perfect matching. Frequency of obesity in the control group was 27.8%, and in the case group was 20,7%. An odds ratio of 0.67 was obtained, with a 95% confidence interval 0.424-1.07 (p value = 0.098). Conclusions: this study did not reveal a statistically significant relationship between obesity and osteoporosis. A protective effect between those variables seems to exist, and it will have to be investigated further.