Comparative Evaluation of Bisphosphonate Effects: Periapical Lesion Frequency, Size, and Radiomorphometric Indices in Osteoporotic Patients

Abstract

Objectives: The aim of the study was to evaluate the effects of bisphosphonate use on periapical lesion frequency, size, and through radiomorphometric indices on jaws. Methods: This study includes 220 postmenopausal women (110 patients who use bisphosphonate and 110 patients who do not use bisphosphonate) with diagnosis of osteoporosis and 110 women who have a healthy bone structure control group. The complex periapical index (CPI), mental index (MI), panoramic mandibular index (PMI), and mandibular cortical index (MCI) values was evaluated. Results: The both right and left MI/PMI means in the osteoporotic patients using bisphosphonate were significantly lower than the others (p < .001). It was found that while the duration of bisphosphonate use increased, the right MI and right-left PMI means decreased significantly (p < .05). The right MI and the right/left PMI means were significantly higher in the group using bisphosphonate via intravenous injection compare to those using it orally. The total number of periapical lesions was significantly less in the group using bisphosphonates than the other two groups (p = .002). The number of teeth with the periapical lesions up to 3 mms in diameter was also significantly lower in the group using bisphosphonate than it was in the other two groups (p = .04). Conclusions:It was found that the use of bisphosphonates is associated with a lower mandibular index, which indicates greater severity of osteoporosis. The total number and size of periapical lesions in these patients were significantly less than the other two groups.