Repercussions of osteoporosis on the maxillofacial complex: a critical overview

J Bone Miner Metab. 2021 Mar;39(2):117-125. doi: 10.1007/s00774-020-01156-4. Epub 2020 Oct 13.

Abstract

Introduction: We present here a literature review focusing on the repercussions of osteoporosis on the oral and maxillofacial complex. Osteoporosis is a silent metabolic disorder characterized by reduced bone mineral density (BMD), which can lead to bone fractures, particularly affecting elderly women. The prevalence of this disease has increased significantly worldwide, and since it accelerates bone resorption also in the jaw bones, some attention has been paid to possible oral and maxillofacial manifestations.

Materials and methods: The databases PubMed and Google Scholar were searched for reports of oral and maxillofacial changes related to osteoporosis.

Results: Several parameters evaluating bone changes in panoramic radiography have been proposed to estimate osteoporosis-related BMD loss, but they tend to warn about the possibility of osteoporosis, rather than being diagnostic criteria. Meanwhile, it seems that osteoporosis-related BMD loss could delay alveolar bone healing and potentiate bone loss in periodontal disease.

Conclusion: Even though orofacial bones are not compromised by osteoporosis as much as the axial/appendicular skeleton, a regular dental follow-up of osteoporotic patients is advised, especially in the case of periodontal disease and maxillofacial surgery. Further controlled longitudinal studies considering the site-specificity of osteogenesis would be helpful regarding this issue.

Keywords: Bisphosphonate-associated osteonecrosis of the jaw; Bone mineral density; Jaws; Mouth; Panoramic radiography.

Publication types

  • Review

MeSH terms

  • Face / pathology*
  • Humans
  • Maxilla / pathology*
  • Osteonecrosis / complications
  • Osteonecrosis / diagnostic imaging
  • Osteoporosis / complications
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / pathology*
  • Periodontal Diseases / complications
  • Radiography, Panoramic