- 期刊
牙周病與骨質疏鬆之關聯性
The Relationship Between Osteoporosis and Periodontitis: A Literature Review
摘要
越來越多的證據顯示，骨質疏鬆症與牙周病和牙齒脫落有關。骨質疏鬆症和牙周炎都是以骨吸收為特徵的疾病。骨質疏鬆症是一種系統性骨骼疾病，其特徵是骨密度低下，骨組織的微結構退化導致骨骼脆弱，因此增加骨折風險。大多數婦女，隨著更年期的開始，骨量的下降有加速的趨勢，並且同時發現口腔症狀以及牙周疾病的惡化。牙周炎長期以來一直被定義為與牙菌斑感染有相關的齒槽骨和牙齒周邊軟組織附著的破壞。骨質疏鬆症和牙周病之間有類似的危險因素，例如年齡，遺傳學，荷爾蒙變化，吸煙，以及鈣和維生素D缺乏症。由於齒槽骨的喪失是牙周疾病的顯著特徵，因此在牙周破壞的情況下，嚴重的骨質疏鬆可能被懷疑是加重因素。本篇文獻回顧就牙周臨床附連高度、齒槽骨高度、牙齒喪失以及齒槽骨密度等因素來進行討論，儘管所節錄的文獻其樣本量大小不一、潛在干擾因素的控制有限、牙周疾病和骨質疏鬆症的定義不一，但就現有的證據指出與同年齡層正常人相比，停經後婦女且罹患骨質疏鬆症，有較高的臨床附連高度喪失、較多的齒槽骨高度喪失、較少的剩餘牙齒數目以及較低的齒槽骨密度。期望利用本篇回顧文獻幫助臨床醫師在牙科治療當中能有效地處理骨質疏鬆症合併牙周發炎的病患。
並列摘要
There is increasing evidences that osteoporosisis correlated with periodontal disease and further tooth loss. Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro architectural deterioration of bone tissue leading to bone fragility, and further increase of risk in fracture. In female population, the decline in bone mass is accelerated with the onset of menopause coincident with different oral symptomsas well as the worsening of periodontal disease. Periodontitis has long been defined as a plaque infection-related destruction of the alveolar bone and soft tissue attachment of the tooth and may result in tooth loss. Osteoporosis and periodontitis both share the similar risk factors in terms of age, genetics, hormonal change, smoking, as well as calcium and vitamin D deficiency. Since loss of alveolar bone is a prominent feature of periodontal disease, severe osteoporosis is presumed to be an aggravating factor in the patients suffered from periodontal destruction. This literature review focus on the factors such as periodontal clinical attachment height, alveolar bone height, the number of tooth loss, and alveolar bone density. Despite the sample size of the excerpted literature is not large, the confounding factors are not well controlled and the definitions of periodontal disease and osteoporosis are different. But depending on the available evidence compared with normal people of the same age, postmenopausal women with osteoporosis or osteopenia may have a higher degree of clinical attachment loss and more severe loss of alveolar bone height, fewer remaining teeth, and lower alveolar bone density. It is hoped that this review paper can help clinicians in managing those patients suffered from both osteoporosis and periodontitis.