아래턱뼈와 척추뼈, 아래팔뼈, 넙다리뼈 뼈밀도 사이의 상관관계
Correlations of Bone Mineral Density between Mandible and Vertebra, Forearm, and Femur
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
골다공증은 뼈량의 감소가 특징적으로 나타나며 골절을 야기시키는 질환이다. 아래턱뼈에서 해면뼈의양상은 몸통뼈대가 골절되는 가능성을 예측할 수 있어 골다공증의 진단과 치료에 활용할 수 있다. 특히, 아래턱뼈의 양적, 질적 평가는 턱끝성형술, 아래턱뼈 절제술, 임플란트 등의 빈도가 증가함에 따라 그 중요성이 높아지고 있으며 아래턱뼈의 뼈밀도와 부피는 시술의 성공여부를 예측하는 결정적인 인자라고 할 수 있다. 본 연구에서는 한국인의 넙다리뼈와 목뼈, 허리뼈, 아래팔뼈의 뼈밀도와 아래턱뼈의 뼈밀도 사이의 연관성을확인하고 어떤 뼈가 아래턱뼈의 뼈밀도를 예측할 수 있는 인자인지 알아보았다. 고정된 한국 성인 시신 42구(남자 22구, 여자 20구, 평균 나이 66.95세)에서 분리한 둘째부터 다섯째목뼈 각42쪽, 첫째부터 넷째허리뼈 각 42쪽, 왼쪽 아래팔뼈 42쪽, 왼쪽 넙다리뼈 42쪽과 아래턱뼈 61개를 대상으로 이중에너지방사선흡수계측기를 이용하여 뼈밀도를 측정하고 분석하였으며 남녀, 연령별로 나누어 SPSS 12.0 프로그램으로 통계적 유의성을 검증한 후 상관관계를 분석하고 골다공성 정도에 따라 분류하여 비교한 후 다음과같은 결과를 얻었다. 1. 턱뼈각의 뼈밀도는 평균 0.40 g/cm2, 턱뼈결합의 뼈밀도는 평균 0.64 g/cm2, 허리뼈의 뼈밀도는 평균 0.76g/cm2, 넙다리뼈목의 뼈밀도는 평균 0.58 g/cm2, 아래팔뼈 먼쪽 1/3 부위 뼈밀도는 평균 0.34 g/cm2, 아래팔뼈 먼쪽 뼈밀도는 평균 0.58 g/cm2이었다. 2. 턱뼈각, 첫째큰어금니와 둘째큰어금니 사이, 첫째큰어금니와 둘째작은어금니 사이, 앞니분절의 뼈밀도는 모두 아래팔뼈 먼쪽 1/3 부위의 뼈밀도와 상관관계가 가장 높았고(r=0.742, 0.697, 0.618, 0.652), 첫째작은어금니와둘째작은어금니 사이는 넙다리뼈목 전체 뼈밀도와 상관관계가 가장 높았다(r=0.542). 3. 아래턱뼈와 넙다리뼈목의 뼈밀도는 모든 항목 중 아래턱뼈각 부위와 넙다리뼈목 전체의 상관관계가 가장높았다. 4. 첫째큰어금니와 둘째큰어금니 사이의 아래턱뼈 뼈밀도는 다섯째목뼈의 뼈밀도와 상관관계가 가장 높았고(r=0.543), 아래턱뼈 앞니 부위의 뼈밀도는 셋째허리뼈와 상관관계가 가장 높았다(r=0.561). 5. 아래턱뼈의 부분별 뼈밀도를 몸통뼈대의 뼈밀도를 기준으로 정상, 골감소증, 골다공증으로 분류하여 비교해본 결과 몸통뼈대의 뼈밀도가 감소하면 아래턱뼈 뼈밀도도 감소하는 경향을 보였다. 이상의 결과를 종합하면 골다공증일 때 몸통뼈대의 부위별 뼈밀도로 아래턱뼈의 뼈밀도 예측이 가능하며 넙다리뼈 돌기사이 부위 또는 아래팔뼈의 뼈밀도를 이용하는 것이 가장 정확도가 높을 것으로 판단된다.
Abstract
Generally, osteoporosis is caused by the age-related physiologic bone loss. In cases of severe osteoporosis,the reduced bone mass and increaed skeletal fragility make the risk of fracture high. Recently, the relationship between the mandible and the condition of the skeletal bone, the molphometric data about the quality and quantity of the mandible are very important in the diagnosis and treatment of osteoporosis. This study was undertaken to clarify the correlations of the mineral density between mandible and other bones,to predict the bone mineral density (BMD) of the mandible. Cervical (2nd~5th) and lumbar (1st~4th) vertebrae, the bones of forearm and proximal femurs, mandibles from 42-embalmed cadavers (22/M, 20/F, mean age: 66.95 years) were examined. The BMD was measured by dual energy X-ray absorptiometry. The data were analysed with SPSS 12.0 program according to age, gender, to verify the statistical significance. 1. The BMD in the mandibular areas were variable. The BMD in the angle of the mandible (mean 0.40 g/cm2)was similar with that of ultra-distal part of the forearm (mean 0.34 g/cm2). 2. The BMD in the mandible was highly correlated with that of around the forearm. The correlation coefficient between density in the angle, the part between 1st and 2nd molar, the part between 1st molar and 2nd premolar and incisor portion of the mandible and density in the 1/3-distal part of the forearm was high (r=0.742, 0.697,0.618, 0.652). The correlation coefficient between density in the part between 1st and 2nd premolar and density in the total femur was high (r=0.542). 3. The BMD in the mandible was correlated with that of around the femur neck (r=0.607). 4. The correlation coefficient between the BMD in the 1st and 2nd molar of the mandible and the BMD in the 5th cervical vertebra was high (r=0.543). And also, the correlation coefficient between the BMD in the incisor area of the mandible and the BMD in the 3rd lumbar vertebra was high (r=0.561). 5. Bony status of the mandible was classified into normal, osteopenia, osteoporosis by BMD of WHO criteria. The data represented that BMD of the mandible was decreased as BMD of the skeletal bones decreased. It is concluded that it could be possible to predict BMD of the mandible by the measurement of BMD in the forearm.
참고문헌 (27)
- Amorim MAL, "Comparative study of axial and femoral bone mineral density and parameters of mandibular bone quality in patients receiving dental implants", Osteoporos Int, 17, pp.1494~1500 (2006)
- Bozic M, "Osteoporosis and mandibles", Dentomaxillofac Radiology, 35, pp.178~184 (2006)
- Büchter A, "Biological and biomechanical evaluation of bone remodeling and implant stability after using an osteotome technique", Clin Oral Implants Res, 16, pp.1~8 (2005)
- Cann CE, "Quantitative computed tomography for prediction of vertebral fracture risk", Bone, 6, pp.1~7 (1985)
- Cho P, "Examination of the bone implant interface in experimentally induced osteoporotic bone", Implant Dent, 13, pp.79~87 (2004)
- Friberg B, "Branemark implants and osteoporosis: a clinical exploratory study", Clin Implant Dent Relat Res, 3, pp.50~56 (2001)
- Honer K, "Mandibular bone mineral density as a predictor of skeletal osteoporosis", Br J Radiol, 69, pp.1019~1025 (1996)
- Honer K, "Detecting patients with low skeletal bone mass", J Dent, 30, pp.171~175 (2002)
- Jonasson G, "Estimation of skeletal bone mineral density by means of the trabecular pattern of the alveolar bone, its interdental thickness, and the bone mass of the mandible", Oral Surg Oral Med Oral pathol Oral Radiol Endod, 92, pp.346~352 (2001)
- Jonasson G, "Changes in the radiographic characteristics of the mandibular alveolar process in dentate women with varying bone mineral density: 5 year prospective study", Bone, 38, pp.714~721 (2006)
- Jonasson G, "Skeletal bone mineral density in relation to thickness, bone mass, and structure of the mandibular alveolar process in dentate men and women", Eur J Oral Sci, 115, pp.117~123 (2007)
- Jonasson G, "Cervical thickness of the mandibular alveolar process and skeletal bone mineral density", Acta Odontol Scand, 57, pp.155~161 (1999)
- Jonasson G, "Changes in the bucco-lingual thickness of the mandibular alveolar process and skeletal bone mineral density in dentate women: a five year prospective study", Eur J Oral Sci, 113, pp.114~120 (2005)
- Kanis JA, "Diagnosis of osteoporosis and fracture threshold in men", Calcif Tissue Int, 69, pp.218~221 (2001)
- Kiliaridis S, "Effects of masticatory muscle function on bone mass in the mandible of the growing rat", Acta Anat, 155, pp.200~205 (1996)
- Kin K, "Bone mineral density of the spine in normal Japanese subjects using dual-energy X-ray absorptiometry: effect of obesity and menopausal status", Calcif Tissue Int, 49, pp.101~106 (1991)
- Klemetti E, "Panoramic mandibular index and bone mineral densities in postmenopausal women", Oral Surg Oral Med Oral Pathol, 75, pp.774~779 (1993)
- Klemetti E, "Cortical bone mineral density in the mandible and osteoporosis status in postmenopausal women", Scand J Dent Res, 101, pp.219~223 (1993)
- Knezovi´c ZD, "Assessment tools in early detection of osteoporosis in dentistry", Arh Hig Rada Toksikol, 58, pp.33~39 (2007)
- Kribbs PJ, "Comparison of mandibular bone in normal and osteoporotic women", J Prosthet Dent, 63, pp.218~222 (1990)
- Kribbs PJ, "Relationships between mandibular and skeletal bone in a population of normal women", J Presthet Dent, 63, pp.86~89 (1990)
- Kribbs PJ, "Relationships between mandibular and skeletal bone in an osteoporotic population", J Prosthet Dent, 62, pp.703~703 (1989)
- Lim LS, "ACPM prevention practice committee: Screening for osteoporosis in the adult U.S. population: ACPM position statement on preventive practice", Am J Prev Med, 36, pp.366~375 (2009)
- Martinez H, "Optimal implant stabilization in low density bone", Clin Oral Implants Res, 12, pp.423~432 (2001)
- Mazess RB, "Bone density of the radius, spine, and proximal femur in osteoporosis", J Bone Miner Res, 3, pp.13~18 (1988)
- Taguchi A, "Oral signs as indicators of possible osteoporosis in elderly women", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 80, pp.612~616 (1995)
- von Wowern N, "Variation in structure within the trabecular bone of the mandible", Scand J Dent Res, 85, pp.613~622 (1977)