Efficacy of the comprehensive antiresorptive therapy at different stages of surgical rehabilitation in dentition defects in female patients with postmenopausal osteoporosis

Abstract

Question of the interrelationship of systemic disorders of bone remodeling and the condition of the bone tissue of the alveolar bone, as well as the efficiency of comprehensive antiresorptive therapy at different stages of surgical rehabilitation in dentition defects in female patients with postmenopausal osteoporosis (PMOP) requires further clarification and remains a subject of active discussion of scientists and clinicians. In the study there was demonstrated that in PMOP female patients with atrophy of the alveolar process of the maxilla in edentulous area there is noted was a significant excess in indices of bone turnover (TNF-alpha level - by 184%, IL-1 - 224%, IL-6- 85%, CTx -156% osteocalcin - 32.9%, PTH- 55%) against the background of the reduced level of a D(OH)25 (by 25.8%) in comparison with patients of reproductive age without osteoporosis. These data correlate with a significant increase in indices of osteosynthesis (index level of the osteoid volume - by 17.6%, index of total resorptive surface by - 51.5%) and a decrease in bone quality indices (index level of the total volume of trabecules - by 60%, index of average width of trabeculae - by 40 %) according to results of the histological examination of bioptate of the process from the edentulous area. At that in PMOP patients with concomitant accompanying somatic pathology the level of TNF-a, IL-1, IL-6 and CTx was significantly higher than in patients of this the group without comorbidity. Appointment of the comprehensive antiresorptive therapy at all stages of surgical rehabilitation (open sinus lifting, dental implantation) in PMOP patients with atrophy of the maxilla in edentulous area during the year before and after sinus lifting significantly increasedthe efficiency of the dental implant. Supplementation of NSAIDs (Arcoxia 60 mg per day) for 2 months prior to dental implantation and within 1 month after a comprehensive antiresorptive therapy in PMOP patients with concomitant estrogen-induced pathology also significantly increases the efficiency of the dental implant in comparison with given indices in patients which received no combined therapy.

Keywords

osteoporosis / dental implantation / atrophy of the alveolar process

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