Assessment of Systemic and Maxillary Bone Loss in Cancer Patients with Endo-Periodontal Lesions Using Dkk-1 Biomarker and Dental Radiological Examinations

Abstract

The aim of our study was to correlate systemic bone loss by evaluating human Dickkopf-related protein 1 (Dkk-1) biomarker compared to horizontal bone loss as well as the presence and size of periapical lesions assessed by dental X-ray (ortopantomography—OPT) and cone beam computed tomography (CBCT) in patients with cancer in the ears, nose and throat (ENT) region vs. healthy controls. The study included 63 subjects divided into a study group of 33 cancer patients with ENT cancer (larynx/oropharynx/sinuses) and a control group of 30 healthy individuals. Blood samples were collected from both groups to assess Dkk-1 level using a sandwich enzyme immunoassay. The dental radiological examination consisted of a panoramic X-ray and a CBCT in order to appraise the horizontal bone loss, the presence and size of the periapical lesions in 2D vs. 3D images. The panoramic X-ray showed that in the control group, the maximum bone loss reached 13.2 mm, with an average of 4.930 ± 3.258 mm, while in the study group, the maximum horizontal bone loss was 11.3 mm, with an average of 5.191 ± 2.109 mm. The CBCT 3D investigation, when compared to the OPT, showed increased values for horizontal bone loss, both in the control group and in the study group; in the control group, the maximum bone loss reached 14.10 mm, with an average of 5.736 ± 3.471 mm, and in the study group, the maximum value was 12.40 mm, and the average was again slightly higher (6.152 ± 2.519 mm). The mean value for Dkk-1 in cancer patients was 1.209 ± 0.110 ng/mL, significantly lower than the value observed in healthy patients (1.712 ± 0.100 ng/mL). CBCT revealed higher values for the investigated parameters when compared to panoramic X-rays. Taking into account the preliminary nature of our study, we observed a significant correlation between the level of bone loss recorded by the Dkk-1 biomarker and radiological dental examination in patients with ENT cancer when compared to the control group.

Odontogenic Sinusitis: From Diagnosis to Treatment Possibilities—A Narrative Review of Recent Data

“…Refinement of CBCT technique brings a number of advantages over classic CT: higher resolution, lower cost, 10% lower irradiation dose when compared to CT, and easier to tolerate for the patient due to shorter examination time and a more comfortable position. CT can create artifacts if hyperdense materials exist in the examination area and it is also less accurate in providing details in examining periodontal and endodontic lesions [ 65 , 66 ]. The benefits of CBCT are evident not only from the arguments presented but also from a statistical point of view: dental infections were not evident in 86% of the initial radiographs whereas they could be detected in 67% of CBCT examinations [ 67 ].…”

Elevated pretreatment lactate dehydrogenase and albumin-to-alkaline phosphatase ratio predict poor prognosis and early treatment discontinuation in head and neck cancer patients with preexistent diabetes mellitus

“…However, the use of antidiabetic medications (metformin) can have beneficial effects by inhibiting tumor metabolic pathways. The biomarker role of LDH and AAPR in HNSCC patients with DM has been less evaluated (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

Management of Odontogenic Sinusitis: Results with Single-Step FESS and Dentoalveolar Surgery

“…The evaluator can examine the sinus–dentoalveolar complex and maxilla in axial, sagittal and coronary views on the image, which offers more details and accuracy for the diagnosis and can help plan the endoscopic surgery. CBCT has a lot of advantages over classic CT, such as a 10% lower irradiation dose compared to CT, shorter examination time, more comfortable position, higher resolution and lower cost [ 15 , 16 ].…”