General and oral aspects of osteoporosis: a review

This review comprises a short summary of up-to-date clinical knowledge on systemic osteoporosis in order to focus on the clinical dental studies on osteoporosis of the jaws, which have become available within the last 15 years. Diagnosis of jaw osteoporosis requires assessment of the bone mineral content (BMC)/density (BMD) using specially constructed jaw bone scanners and development of a corresponding gender-related set of normal BMC/BMD values for young adults, as in other sites of the skeleton. If other factors are excluded, jaw osteoporosis may involve the risk of minor accentuation of alveolar bone loss after wearing a full denture, in cases of periodontitis and in peri-implant areas. However, implant-supported overdentures conserve bone because of their positive load-related effect on the jaw. Estimation of BMC/BMD is also advisable for edentulous osteoporotic patients. Systemic treatment involving the bone metabolism affects the jaw BMC/BMD positively or negatively as in other skeletal sites, but the magnitude of this effect is site-specific. Future studies of the effect of bisphosphonates on the jaw BMC and alveolar bone loss, and analyses of the bone quality and jaw BMC/BMD in relation to implant treatment, without or with bone transplantation, are required.