骨粗鬆症を伴う要介護高齢者に対するアレンドロネート長期投与による歯周組織変化

抄録

The prevalences of osteoporosis and periodontitis are very high in long-term facilities, so the quality of life becomes lower. The air of this study was to evaluate the effects of alendronate for the periodontium of elderly people in long-term homes. The subjects were 21 elderly people who lived in nursing homes. They were split into two groups: the drug-taking group (test group of 12 subjects) and the non-drug-taking group (control group of nine subjects). We had them take 'Fosamac' (5 mg) in the morning once a day for 21 months. The tooth of study was the voluntary canine. However, if this tooth was missing, another tooth was selected for research. Clinical periodontal parameters (GI, gingival index; PlI, plaque index; PD, pocket depth; LA, loss of attachment; BOP, bleeding on probing), bone mineral density (the methods of CXD: computed X-ray densitometry; DXA: dual X-ray absorptiometry; and QUS: quantitative ultrasound), and NTx (crosslinked N-telopeptides of type I collagen) were examined at baseline and at 7, 14, and 21 months after the beginning of the drug consumption. In addition, dental X-ray photographs to examine BL (bone loss) were taken during the same periods. Significant decreases in NTx were found between the baseline and 7 and 14 months in the test group, and the difference between baseline and 21 months in the test group increased. PD tended to improve in the test group, but it did not change significantly in the control group. BL did not change during the research periods in the test group, although it tended to increase in the control group. In contrast, differences of other clinical periodontal parameters during the study period were not found between the two groups including the bone mineral density (CXD, DXA, and QUS). These results suggest that alendronate possibly prevents periodontitis from becoming worse, although it does not improve the periodontium in the nursing home patients.