中国口腔种植学杂志 ›› 2024, Vol. 29 ›› Issue (4): 303-310.DOI: 10.12337/zgkqzzxzz.2024.08.003
柳忠豪1,2, 董凯1
收稿日期:2024-04-18
出版日期:2024-08-30
发布日期:2024-08-16
通讯作者:
柳忠豪,Email:dentlzh@163.com,电话:0535-6215913
作者简介:柳忠豪 博士、主任医师、教授、博士研究生导师; 滨州医学院口腔医学院、烟台市口腔医院院长,兼任国际口腔种植学会(ITI)中国分会教育部主任、专家组成员(ITI Fellow),中国牙病防治基金会副理事长,中华口腔医学会口腔种植专业委员会常务委员、口腔医学计算机专业委员会常务委员、口腔美学专业委员会常务委员、口腔医学教育专业委员会委员,国际牙医师学院(ICD)院士,山东省口腔医学会副会长、口腔医学美学专业委员会主任委员、口腔种植专业委员会候任主任委员,烟台市口腔医学会会长; 在国内外核心期刊发表论文100余篇,主持/参编/参译著作10余部,任《口腔医学研究》杂志副主编及《上海口腔医学》《中国口腔种植学杂志》等多家国内专业期刊编委,指导和培养博士、硕士研究生40余名; 专业特长:各类牙缺失的口腔种植修复治疗,数字化微创精准口腔种植治疗,各种复杂骨增量技术,种植并发症的防治等; 董凯 博士、副主任医师; 国际口腔种植学会(ITI)会员; 在国内外核心期刊发表论文10余篇,参编/参译著作3部; 研究方向:种植体骨结合、骨组织再生; 专业特长:各类牙缺失的口腔种植修复治疗,数字化微创精准口腔种植治疗,各种复杂骨增量技术, 种植并发症的防治等。董凯 博士、副主任医师。国际口腔种植学会(ITI)会员。在国内外核心期刊发表论文10 余篇,参编/参译著作3部。研究方向:种植体骨结合、骨组织再生。专业特长:牙列缺损及缺失的种植外科及修复治疗。
Liu Zhonghao1,2, Dong Kai1
Received:2024-04-18
Online:2024-08-30
Published:2024-08-16
Contact:
Liu Zhonghao, Email: 摘要: 骨质疏松症是一种全身性骨骼疾病,以骨密度降低及骨量减少为主要特征。随着我国人口老龄化程度加剧,骨质疏松的发病率也逐年上升。作为牙缺失的首选治疗方法,种植牙具有很高的留存率,但对于骨质疏松患者,骨组织微结构的损坏可能会导致口腔种植治疗失败的风险增高。虽然骨质疏松不是口腔种植治疗的禁忌证,但是临床医生仍应高度重视相关风险因素。本文对骨质疏松患者的牙槽骨塑形及改建、种植牙留存率、抗骨质疏松药物的影响以及牙种植治疗策略这几方面进行探讨,以供临床参考。
柳忠豪,董凯. 骨质疏松症患者口腔种植治疗的风险与对策[J]. 中国口腔种植学杂志, 2024, 29(4): 303-310. DOI: 10.12337/zgkqzzxzz.2024.08.003
Liu Zhonghao, Dong Kai. Risks and countermeasures of dental implant treatment in osteoporosis patients[J].Chinese Journal of Oral Implantology, 2024, 29(4): 303-310.DOI: 10.12337/zgkqzzxzz.2024.08.003.
| [1] 中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症诊疗指南(2022)[J].中国全科医学, 2023, 26(14):1671-1691. DOI: 10.12114/j.issn.1007-9572. 2023.0121. [2] 中华医学会骨质疏松和骨矿盐疾病分会. 中国骨质疏松症流行病学调查及"健康骨骼"专项行动结果发布[J]. 中华骨质疏松和骨矿盐疾病杂志, 2019,12(4):317-318. [3] Wagner F, Schuder K, Hof M, et al.Does osteoporosis influence the marginal peri-implant bone level in female patients? A cross-sectional study in a matched collective[J]. Clin Implant Dent Relat Res, 2017,19(4):616-623. DOI: 10.1111/cid.12493. [4] Lemos C, de Oliveira AS, Faé DS, et al. Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis[J]. Clin Oral Investig, 2023,27(6):2483-2493. DOI: 10.1007/s00784-023-05005-2. [5] Arioka M, Zhang X, Li Z, et al.Osteoporotic changes in the periodontium impair alveolar bone healing[J]. J Dent Res, 2019,98(4):450-458. DOI: 10.1177/0022034518818456. [6] Chambrone L.Current status of the influence of osteoporosis on periodontology and implant dentistry[J]. Curr Opin Endocrinol Diabetes Obes, 2016,23(6):435-439. DOI: 10.1097/MED.0000000000000272. [7] Singhal S, Chand P, Singh BP, et al.The effect of osteoporosis on residual ridge resorption and masticatory performance in denture wearers[J]. Gerodontol, 2012,29(2):e1059-e1066. DOI: 10.1111/j.1741-2358.2011.00610.x. [8] Lu B, Zhang X, Liu B.A systematic review and meta-analysis on influencing factors of failure of oral implant restoration treatment[J]. Ann Palliat Med, 2021,10(12):12664-12677. DOI: 10.21037/apm-21-3449. [9] Lotz EM, Cohen DJ, Schwartz Z, et al.Titanium implant surface properties enhance osseointegration in ovariectomy induced osteoporotic rats without pharmacologic intervention[J]. Clin Oral Implants Res, 2020,31(4):374-387. DOI: 10.1111/clr.13575. [10] Overmann AL, Aparicio C, Richards JT, et al.Orthopaedic osseointegration: implantology and future directions[J]. J Orthop Res, 2020,38(7):1445-1454. DOI: 10.1002/jor.24576. [11] Monje A, Ravidà A, Wang HL, et al.Relationship between primary/mechanical and secondary/biological implant stability[J]. Int J Oral Maxillofac Implants, 2019,34:S7-S23. DOI: 10.11607/jomi.19suppl.g1. [12] Merheb J, Temmerman A, Rasmusson L, et al.Influence of skeletal and local bone density on dental implant stability in patients with osteoporosis[J]. Clin Implant Dent Relat Res, 2016,18(2):253-260. DOI: 10.1111/cid.12290. [13] 宿玉成. 口腔种植学: 第2版 [M]. 北京:人民卫生出版社, 2014. [14] Fini M, Giavaresi G, Torricelli P, et al.Osteoporosis and biomaterial osteointegration[J]. Biomed Pharmacother, 2004,58(9):487-493. DOI: 10.1016/j.biopha.2004.08.016. [15] Zhou Y, Hu Z, Ge M, et al.Intraosseous injection of calcium phosphate polymer-induced liquid precursor increases bone density and improves early implant osseointegration in ovariectomized rats[J]. Int J Nanomedicine, 2021,16:6217-6229. DOI: 10.2147/IJN.S321882. [16] 葛畅, 孟维艳. 骨质疏松症患者种植修复的研究进展[J].中华老年口腔医学杂志,2023,21(3):173-177. DOI: 10.19749/j.cn.cjgd.1672-2973.2023.03.010. [17] Temmerman A, Rasmusson L, Kübler A, et al. A prospective, controlled, multicenter study to evaluate the clinical outcome of implant treatment in women withosteoporosis/osteopenia: 5-year results[J]. J Dent Res, 2019,98(1):84-90. DOI: 10.1177/0022034518798804. [18] Liapaki A, Chen Y, Hadad H, et al.Evaluation of oral implant survival rate in postmenopausal women with osteopenia/osteoporosis. A retrospective pilot study[J]. J Stomatol Oral Maxillofac Surg, 2022,123(6):e777-e781. DOI: 10.1016/j.jormas.2022.06.023. [19] Albrektsson T, Zarb G, Worthington P, et al.The long-term efficacy of currently used dental implants: a review and proposed criteria of success[J]. Int J Oral Maxillofac Implants, 1986,1(1):11-25. [20] Lemos C, Verri FR, Noritomi PY, et al. Effect of bone quality and bone loss level around internal and external connection implants: a finite element analysis study[J]. J Prosthet Dent, 2021,125(1):137.e1-137.e10. DOI: 10.1016/j.prosdent.2020.06.029. [21] Davies JE.Understanding peri-implant endosseous healing[J]. J Dent Educ, 2003,67(8):932-949. [22] Simons WF, De Smit M, Duyck J, et al.The proportion of cancellous bone as predictive factor for early marginal bone loss around implants in the posterior part of the mandible[J]. Clin Oral Implants Res, 2015,26(9):1051-1059. DOI: 10.1111/clr.12398. [23] Tabrizi R, Mousavi F, Ghasemi S, et al.Does osteoporosis increase marginal bone loss around dental implants in the posterior of the maxilla?[J]. Int J Oral Maxillofac Surg, 2021,50(7):964-968. DOI: 10.1016/j.ijom.2020.12.001. [24] 中国药学会医院药学专业委员会. 骨质疏松症治疗药物合理应用专家共识(2023)[J].中国医院药学杂志, 2024,44(9):985-1006. DOI: 10.13286/j.1001-5213. 2024.09.01. [25] Soares AP, do Espírito Santo RF, Line SR, et al. Bisphosphonates: pharmacokinetics, bioavailability, mechanisms of action, clinical applications in children, and effects on tooth development[J]. Environ Toxicol Pharmacol, 2016,42:212-217. DOI: 10.1016/j.etap.2016.01.015. [26] Tsolaki IN, Madianos PN, Vrotsos JA.Outcomes of dental implants in osteoporotic patients. A literature review[J]. J Prosthodont, 2009,18(4):309-323. DOI: 10.1111/j.1532-849X.2008.00433.x. [27] Dental management of patients receiving oral bisphosphonate therapy: expert panel recommendations[J]. J Am Dent Assoc, 2006,137(8):1144-1150. DOI: 10.14219/jada.archive.2006.0355. [28] Gelazius R, Poskevicius L, Sakavicius D, et al.Dental implant placement in patients on bisphosphonate therapy: a systematic review[J]. J Oral Maxillofac Res, 2018,9(3):e2. DOI: 10.5037/jomr.2018.9302. [29] Kwon TG, Lee CO, Park JW, et al.Osteonecrosis associated with dental implants in patients undergoing bisphosphonate treatment[J]. Clin Oral Implants Res, 2014,25(5):632-640. DOI: 10.1111/clr.12088. [30] Vohra F, Al-Rifaiy MQ, Almas K, et al.Efficacy of systemic bisphosphonate delivery on osseointegration of implants under osteoporotic conditions: lessons from animal studies[J]. Arch Oral Biol, 2014,59(9):912-920. DOI: 10.1016/j.archoralbio.2014.05.016. [31] Chen B, Li Y, Yang X, et al.Zoledronic acid enhances bone-implant osseointegration more than alendronate and strontium ranelate in ovariectomized rats[J]. Osteoporos Int, 2013,24(7):2115-2121. DOI: 10.1007/s00198-013-2288-7. [32] Cheng YC, Ewers R, Morgan K, et al.Antiresorptive therapy and dental implant survival: an up to 20-year retrospective cohort study in women[J]. Clin Oral Investig, 2022,26(11):6569-6582. DOI: 10.1007/s00784-022-04609-4. [33] Ervolino da Silva AC, de Souza Batista FR, Hassumi JS, et al. Improvement of peri-implant repair in estrogen-deficient rats fed a cafeteria diet and treated with risedronate sodium[J]. Biology (Basel), 2022,11(4):578. DOI: 10.3390/biology11040578. [34] Stavropoulos A, Bertl K, Pietschmann P, et al.The effect of antiresorptive drugs on implant therapy: systematic review and meta-analysis[J]. Clin Oral Implants Res, 2018,29(Suppl 18):S54-S92. DOI: 10.1111/clr.13282. [35] Al-Nawas B, Lambert F, Andersen S, et al.Group 3 ITI consensus report: materials and antiresorptive drug-associated outcomes in implant dentistry[J]. Clin Oral Implants Res, 2023,34(Suppl 26):S169-S176. DOI: 10.1111/clr.14135. [36] 中华医学会骨质疏松和骨矿盐疾病分会. 地舒单抗在骨质疏松症临床合理用药的中国专家建议[J].中华骨质疏松和骨矿盐疾病杂志,2020,13(6):499-508. DOI: 10.3969/j.issn.1674-2591.2020.06.002. [37] Park S, Heo HA, Min JS, et al.Effect of raloxifene on bone formation around implants in the osteoporotic rat maxilla: histomorphometric and microcomputed tomographic analysis[J]. Int J Oral Maxillofac Implants, 2020,35(2):249-456. DOI: 10.11607/jomi.7811. [38] Park S, Heo HA, Kim KW, et al.Expression of osteogenic markers after administration of selective estrogen receptor modulators during implant placement in the osteoporotic rat maxilla[J]. J Oral Sci, 2022,64(1):53-58. DOI: 10.2334/josnusd.21-0316. [39] de Souza Santos AM, Dos Santos Pereira R, Montemezzi P, et al. The interplay of raloxifene and sonochemical bio-oss in early maxillary sinus bone regeneration: a histological and immunohistochemical analysis in rabbits[J]. Medicina (Kaunas), 2023,59(9):1521. DOI: 10.3390/medicina59091521. [40] Apostu D, Lucaciu O, Lucaciu GD, et al.Systemic drugs that influence titanium implant osseointegration[J]. Drug Metab Rev, 2017,49(1):92-104. DOI: 10.1080/03602532.2016.1277737. [41] Chen BL, Xie DH, Zheng ZM, et al.Comparison of the effects of alendronate sodium and calcitonin on bone-prosthesis osseointegration in osteoporotic rats[J]. Osteoporos Int, 2011,22(1):265-270. DOI: 10.1007/s00198-010-1186-5. [42] Januário AL, Sallum EA, de Toledo S, et al. Effect of calcitonin on bone formation around titanium implant. A histometric study in rabbits[J]. Braz Dent J, 2001,12(3):158-162. [43] Nociti FH Jr, Sallum AW, Sallum EA, et al.Effect of estrogen replacement and calcitonin therapies on bone around titanium implants placed in ovariectomized rats: a histometric study[J]. Int J Oral Maxillofac Implants, 2002,17(6):786-792. [44] Chiba K, Okazaki N, Kurogi A, et al.Randomized controlled trial of daily teriparatide, weekly high-dose teriparatide, or bisphosphonate in patients with postmenopausal osteoporosis: the TERABIT study[J]. Bone, 2022,160:116416. DOI: 10.1016/j.bone.2022.116416. [45] Gomes-Ferreira P, de Oliveira D, Frigério PB, et al. Teriparatide improves microarchitectural characteristics of peri-implant bone in orchiectomized rats[J]. Osteoporos Int, 2020,31(9):1807-1815. DOI: 10.1007/s00198-020-05431-y. [46] Kim JY, Park JH, Jung HD, et al.Treatment of medication-related osteonecrosis of the jaw around the dental implant with a once-weekly teriparatide: a case report and literature review[J]. J Oral Implantol, 2019,45(5):403-407. DOI: 10.1563/aaid-joi-D-19-00040. [47] Zidrou C, Kapetanou A, Rizou S.The effect of drugs on implant osseointegration - a narrative review[J]. Injury, 2023,54(8):110888. DOI: 10.1016/j.injury.2023.110888. [48] Miller PD, Adachi JD, Albergaria BH, et al.Efficacy and safety of romosozumab among postmenopausal women with osteoporosis and mild-to-moderate chronic kidney disease[J]. J Bone Miner Res, 2022,37(8):1437-1445. DOI: 10.1002/jbmr.4563. [49] Falco A, Berardini M, Trisi P.Correlation between implant geometry, implant surface, insertion torque, and primary stability: in vitro biomechanical analysis[J]. Int J Oral Maxillofac Implants, 2018,33(4):824-830. DOI: 10.11607/jomi.6285. [50] Cinar D, Imirzalioglu P.The effect of three different crown heights and two different bone types on implants placed in the posterior maxilla: three-dimensional finite element analysis[J]. Int J Oral Maxillofac Implants, 2016,31(2):e1-e10. DOI: 10.11607/jomi.4048. [51] Andrés-García R, Vives NG, Climent FH, et al.In vitro evaluation of the influence of the cortical bone on the primary stability of two implant systems[J]. Med Oral Patol Oral Cir Bucal, 2009,14(2):e93-e97. [52] Hindi AR, Bede SY.The effect of osseodensification on implant stability and bone density: a prospective observational study[J]. J Clin Exp Dent, 2020,12(5):e474-e478. DOI: 10.4317/jced.56727. [53] Alghamdi HS.Methods to improve osseointegration of dental implants in low quality (type-IV) bone: an overview[J]. J Funct Biomater, 2018,9(1):7. DOI: 10.3390/jfb9010007. [54] Sun X, Yang S, Tong S, et al.Study on exosomes promoting the osteogenic differentiation of adscs in graphene porous titanium alloy scaffolds[J]. Front Bioeng Biotechnol, 2022,10:905511. DOI: 10.3389/fbioe.2022.905511. [55] 张婷婷, 李潇, 刘莉. 骨质疏松状态下不同种植体表面涂层改性技术对种植体骨结合的影响[J].口腔颌面修复学杂志, 2023,24(5):395-400. DOI: 10.19748/j.cn.kqxf.1009-3761. 2023.5.014. |
| [1] | 刘鲁鹏, 肖慧娟. 倾斜型上颌窦底穿牙槽嵴上颌窦底提升的临床研究进展[J]. 中国口腔种植学杂志, 2025, 30(6): 604-609. |
| [2] | 徐业豪, 任碧晖, 戴婕婷, 郭水根, 魏洪武. 不同初始生物学宽度对单纯锥度固位种植体边缘骨吸收的影响[J]. 中国口腔种植学杂志, 2025, 30(5): 440-448. |
| [3] | 汤明超, 曾庆祥, 张小燕. 局部使用盐酸米诺环素联合常规抗生素对伴局限性牙周炎的种植术后感染患者菌斑指数及sICAM-1、IL-1β的影响[J]. 中国口腔种植学杂志, 2025, 30(4): 363-369. |
| [4] | 陈莉, 周文娟, 柳忠豪. 种植体植入深度对种植体周组织影响的研究进展[J]. 中国口腔种植学杂志, 2025, 30(4): 393-398. |
| [5] | 王英杰, 王梦雪, 曹语, 许姿曼, 徐雨欧, 刘乐华. 表面处理技术对牙种植体骨结合影响的研究进展[J]. 中国口腔种植学杂志, 2025, 30(4): 405-411. |
| [6] | 李昕茹, 曹泽鹏, 刘一伯, 韩泽奎, 周立波. 不同螺纹种植体即刻种植即刻负荷的比格犬体内实验[J]. 中国口腔种植学杂志, 2025, 30(3): 255-261. |
| [7] | 万克, 郝俊江, 宿瀚奇, 宿玉成. 不同颈圈对种植体边缘骨吸收影响的Meta分析[J]. 中国口腔种植学杂志, 2025, 30(3): 275-280. |
| [8] | 付丽, 周延民. 富血小板纤维蛋白在种植体周围软组织增量中的应用研究[J]. 中国口腔种植学杂志, 2025, 30(2): 98-105. |
| [9] | 吕慧欣, 周延民. 富血小板纤维蛋白在上颌窦底提升中应用的研究进展[J]. 中国口腔种植学杂志, 2025, 30(2): 127-134. |
| [10] | 王子扬, 马旭东. 成骨/破骨细胞轴对糖尿病骨代谢影响的研究进展[J]. 中国口腔种植学杂志, 2025, 30(2): 176-179. |
| [11] | 蔡雯昱, 马骏驰, 赵文博, 王一茗, 周立波. 种植体构型设计的特点与临床应用现状[J]. 中国口腔种植学杂志, 2025, 30(2): 180-186. |
| [12] | 徐邢环宇, 杨艳兰, 徐普, 郁豆, 陆丽英. 重度咽反射患者多牙种植手术经验分享1例[J]. 中国口腔种植学杂志, 2025, 30(1): 81-85. |
| [13] | 刘奇奇, 赵雨佳, 邱林, 郝俊江, 宿瀚奇, 韩泽奎, 王心彧, 宿玉成. 不同喷砂参数对医用四级纯钛表面粗糙度的影响[J]. 中国口腔种植学杂志, 2024, 29(6): 555-560. |
| [14] | 邱韵, 王宇蓝, 张玉峰. 骨质疏松症对牙种植的影响及临床考量[J]. 中国口腔种植学杂志, 2024, 29(4): 336-341. |
| [15] | 赵昕彤, 孟维艳. 抑郁症对种植体周健康状态影响的研究进展[J]. 中国口腔种植学杂志, 2024, 29(4): 342-346. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||