インプラント治療におけるリスクファクターの明確化：骨代謝マーカー検査によるスクリーニング （パイロットスタディ)

抄録

Objective: There are approximately 11 million osteoporosis patients in Japan today. Although osteoporosis is known as a risk factor for dental implant treatment, no studies have investigated how the pathogenesis of osteoporosis after implantation is related to dental implant failure. Bone metabolic markers are used to ascertain bone quality in orthopedics, and have been suggested to be indicators of osteoporosis. The aim of this pilot study was to investigate the ratio of patients with abnormal bone metabolic marker values to determine their suitability for use as indicators of the risk of implant failure.
Methods: Samples were obtained from 488 patients (men: 148, women: 340) visiting the Department of Oral and Maxillofacial Implantology, Tokyo Dental College Chiba Hospital between May 2005 and April 2008. Urinary deoxypyrinoline (DPD), urinary type I collagen N-telopeptide (NTx), bone specific alkaline phosphatase (BAP), osteocalcin (OC), parathyroid hormone (PTH), serum calcium (Ca) and inorganic phosphorus (P) were selected as biochemical markers of bone metabolism.
Results: Forty-seven percent showed abnormal values for the metabolic markers selected. Regarding parameters related to the pathogenesis of osteoporosis, low values for OC and BAP as osteogenesis markers and high values for NTx and DPD as bone resorption markers were recognized in 13.8%. The ratio of men with low osteogenesis markers was higher than that of women. On the other hand, the ratio of women with low bone resorption markers was higher.
Conclusion: Some implant patients have anomalous metabolic values, suggesting a risk of developing osteoporosis in the future. Based on these results, investigating the relationship between chronological changes in these parameters and the survival rate of implants would clarify the suitability of bone metabolic markers as indicators of the risk of implant failure.