老年性骨质疏松症动物模型及其发病机制的研究进展

老年性骨质疏松症（SOP）是生物衰老在骨骼方面的一种特殊表现,对老年人的健康和生活质量造成了严重的威胁。随着人口老龄化的加快,如何防治SOP及其引发的骨折不仅成为了医学界急需解决的问题,也是一个社会化问题。建立合适的SOP动物模型能更好地指导其发病机理的探究,并为新药的研发提供帮助。本文主要总结了近几年来应用较多的3种SOP动物模型,包括SAMP6快速老化SOP动物模型、D-半乳糖致衰老性SOP动物模型、自然衰老性SOP动物模型,并对以上动物模型各自的发病机制进行综述。     

大豆异黄酮对去势大鼠骨质疏松性骨折愈合的影响

目的研究大豆异黄酮在大鼠骨质疏松性骨折愈合过程中的干预效果。方法将50只6月龄雌性SD大鼠随机分成5组:正常对照组、骨折组、骨质疏松组、骨质疏松性骨折组、骨质疏松性骨折治疗组,每组10只。正常对照组、骨折组只进行手术入路而不切除卵巢。骨质疏松组、骨质疏松性骨折组、骨质疏松性骨折治疗组摘除双侧卵巢制备骨质疏松模型。8周后,骨折组、骨质疏松性骨折组、骨质疏松性骨折治疗组制备右侧股骨干中段横行骨折模型。骨质疏松性骨折治疗组每日灌胃大豆异黄酮50 mg/kg(剂量1.5 ml/kg),骨折组、骨质疏松性骨折组灌胃等量生理盐水,连续8周。结果去卵巢后8周,骨质疏松组的骨密度显著低于正常对照组(P0.05),说明骨质疏松模型制作成功。灌胃8周后,骨质疏松性骨折组骨痂组织骨小梁数量及致密度、骨密度、血管内皮细胞生长因子的表达均显著低于骨折组和骨质疏松性骨折治疗组(P0.05)。结论大豆异黄酮在大鼠骨质疏松性骨折愈合过程中具有积极促进作用。     

PKP与“五点式”支撑复位综合疗法治疗新鲜骨质疏松性胸腰椎压缩骨折疗效比较

目的:观察经皮椎体后凸成形术(PKP)与"五点式"支撑复位综合疗法治疗新鲜骨质疏松性胸腰椎压缩骨折(OVCFs)在缓解疼痛、矫正脊柱后凸畸形、改善患者生活质量及邻近再骨折发生率、骨密度改善等方面的效果。方法:回顾性分析OVCFs患者74例,其中37例行PKP手术治疗(A组),37例行"五点式"支撑复位综合疗法治疗(B组),术后常规拍摄伤椎及其邻近阶段X线片,行骨密度检查,2组治疗后6、12、24个月进行随访,记录患者疼痛视觉模拟评分(VAS)、伤椎前缘高度、后凸Cobb角、Oswesty功能障碍指数(ODI)、邻近再骨折发生率、骨密度改善情况。结果:A组伤椎前缘高度恢复、后凸畸形矫正、疼痛缓解及功能活动、骨密度改善等方面均优于B组,差异有统计学意义(P0.05)。A组与B组邻近节段发生骨折率分别为8.1%和18.9%,差异有统计学意义(P0.05)。结论:PKP能使OVCFs患者的腰背疼痛得到有效缓解,能矫正后凸畸形,改善患者生活质量,降低邻近阶段骨折的再发生。     

维、汉老年男性代谢综合征患者骨代谢相关因素分析

目的:探讨新疆维吾尔族和汉族男性代谢综合征(MS)患者骨代谢水平的特点。方法:采用双能X线法检测216例新疆维吾尔族老年男性代谢综合征患者和258例汉族老年男性代谢综合征患者骨密度,空腹抽血检测血清总睾酮(T)、血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血钙(Ca)、25羟维生素D(25OHvit D),血红蛋白(Hb)、测量血压(SBP、DBP)、计算体质指数(BMI)。结果:MS组与非MS组间T值、BMI、SBP、Hb组间存在统计学差异;代谢综合征患者Hb水平高于于非代谢综合征患者,在男性维吾尔族男性代谢综合征患者中,MS组空腹血糖高于非MS组。MS组中BMI值与FBG存在民族差异;同样在OP组中,BMI值与FBG存在民族差异。MS组中骨质疏松患者中睾酮水平有民族差异,OP组中MS患者有民族差异;均提示相关分析及协方差分析亦提示睾酮对骨密度值均有影响。结论:维、汉民族间BMI越大,骨密度越高;血糖控制与BMI相关;维吾尔老年男性代谢综合征合并骨质疏松患者睾酮水平高于汉族男性患者。     

Bone health and oral health

BACKGROUND: Low bone mass in the skeleton, which increases the risk of osteoporotic fracture, also may be associated with periodontal bone loss and tooth loss. Osteoporosis and periodontal disease share several common risk factors, including older age, smoking and perhaps insufficient dietary intakes of calcium and vitamin D. CONCLUSION: Research supports the idea that osteoporosis independently influences alveolar bone height loss. Strategies for reducing osteoporosis risk also may help retard alveolar bone loss. Meeting dietary intake recommendations for calcium and vitamin D is one strategy that is appropriate for a broad segment of the population. CLINICAL IMPLICATIONS: A healthy lifestyle has multiple benefits for the mouth and throughout the body. Dental professionals can play a role in preventing osteoporosis by reinforcing this message.     

糖皮质激素性骨质疏松与口腔疾病

随着糖皮质激素在临床上的广泛应用,糖皮质激素性骨质疏松症发病率明显增加。口腔颌面部作为全身骨组织的重要组成部分,其与糖皮质激素性骨质疏松的联系也日益受到关注。该文就国内外有关糖皮质激素性骨质疏松对颌骨、牙槽骨、牙齿的影响,以及其与牙周炎、牙种植和口腔正畸治疗的关系等方面的研究状况作一综述。     

Osteoporosis and Osseointegration of Implants

According to medical literature, osteoporosis and related bone pathologies are increasing in epidemic proportions. The exact etiology of the disease is unknown, but hormonal, dietary, and genetic factors all contribute to the related loss of bone density. In the disease process, bone loss occurs throughout the body. Research indicates that the mandible and maxilla are affected, and show oral manifestations. There is no scientific data to contraindicate the use of two-step osseointegrated implants in osteoporotic individuals. The purpose of this article is to review the literature regarding osteoporosis and its relationship to oral bone loss.     

The effect of SLActive surface in guided bone formation in osteoporotic-like conditions

Objectives: The aim of the study was to evaluate new bone formation under etched titanium (SLA) and modified‐etched hydrophilic titanium (modSLA) domes placed on the calvarium of healthy, osteoporotic and osteoporotic treated with bisphosphonates rabbits. Methods: Experimental osteoporosis was induced by ovariectomy (OV) and calcium‐deficient diet in 24 New Zealand female rabbits. Twelve OV rabbits were treated with weekly dozes of alendronate (Fosamax^®) (B) while 12 OV rabbits received no treatment (O). Another 12 rabbits were sham operated and used as healthy controls (C). At 6 weeks following OV, one modSLA and one SLA titanium dome were placed in the parietal bones of each rabbit. The animals were sacrificed at 30 and 120 days following the dome placement. Various histomorphometric measurements were performed in the most central of the undecalcified sections produced. Results: After 30 days of healing, in the C group, the total bone (TB) area was 37.6% and 37.0% under the modSLA and SLA domes, respectively. In the O group, the TB was 35.7% and 24.8%. In the B group, TB was 37.0% and 32.1%, respectively. After 120 days of healing, in the C group TB was 40.1% and 36.4%, respectively. In the O group, TB was 29.6% and 27.9%, respectively. In the B group, TB was 49.7% and 42.5%, respectively. Hierarchical analysis of variance showed that the type of titanium dome significantly influenced new bone and the amount of new bone being in contact with inner surface of the dome (BIC) independently of the observation period and group (P<0.05). The administration of bisphosphonates influenced the BIC (P<0.05). Conclusion: The use of modSLA surface may promote bone healing and osseointegration in osteoporotic rabbits, whereas administration of bisphosphonates may compromise the osseointegration of the newly formed bone at the early healing period. To cite this article:
Mardas N, Schwarz F, Petrie A, Hakimi A‐R, Donos N. The effect of SLActive surface in guided bone formation in osteoporotic‐like conditions.
Clin. Oral Impl. Res. 22 , 2011; 406–415.
doi: 10.1111/j.1600‐0501.2010.02094.x     

Attachment loss with postmenopausal age and smoking

To determine whether postmenopausal bone loss and factors associated with osteoporosis affect tooth retention, we examined vertebral and proximal femoral (postcranial) bone mineral density in relation to tooth loss and attachment loss in a cross-sectional study of 135 postmenopausal women (age range 41–70 yr). Women had at least 10 teeth and no evidence of moderate or severe periodontal disease. Full-mouth attachment loss measurements were made using a pressure-sensitive probe, and bone density was determined by dual-energy X-ray absorptiometry. Attachment loss was correlated with tooth loss (number of remaining teeth, radiologically determined), but not with vertebral or proximal femur bone density. Multivariate analysis showed current smoking (p = 0.01), years since menopause (p = 0.02) and the interaction of age and current smoking (p < 0.01), to be statistically significant predictors of attachment loss in our study population.