Effect Of The Treatment Of Zoledronic Acid On The Patients With Osteoporosis And Periodontitis

Background:After menopause, the ovarian function of the women is declined and female hormone level in the body is decreased rapidly, which can easily lead to the occurrence of menopausal osteoporosis. Osteoporosis is a common disease in the elderly, especially in postmenopausal women, the incidence of the disease is high and affects the health and quality of life of the elderly. The main manifestation of osteoporosis is decreased bone mass and the early bone change mainly occurs in cancellous bone region, which is rich in bone. The cancellous bone has rich blood, fast metabolism and more sensitive to reactivity of various stimuli than cortical bone, and bone hyperplasia fibrosis degeneration leads to increased bond fragility. Osteoporosis becomes China’s important public health problem. The study found that, about 25% menopausal women have osteoporosis and at the growth of the age, the osteoporosis symptoms of lumbar intervertebral disc, etc, parts are increasingly obvious.Chronic periodontitis is a chronic infectious disease occurred in periodontal support tissue, under interactions of initial factor plaque and host immune system, it causes the loss of periodontal connective tissue attachment and the absorption of alveolar bone, eventually leads to the loosening and displacement of teeth. Chronic periodontitis is one of the two most major oral diseases to cause dentition defect. As a chronic infectious disease, the host factor plays an important role in clinical and pathological changes of chronic periodontitis. Chronic periodontitis is closely related to systemic disease of the body, in recent years, the studies on relationship between menopausal osteoporosis and chronic periodontitis have received more and more attention. However, there is no definite conclusion yet on whether the occurrence and development between menopausal osteoporosis and chronic periodontitis have certain correlation. Many Chinese and foreign scholars have carried out scientific experiments and studies in this area, some people support the view of menopausal osteoporosis and chronic periodontitis have correlation and some people think that there is no correlation, even the scholars of agreeing the two have correlation, the related factors insisted by them are not the same. The first part of the study involves 220 postmenopausal women of First Affiliated Hospital of Zhengzhou University and Zhangqiu Municipal People’s Hospital, to explore the correlation between bone mass level of menopausal osteoporosis and clinical parameters of chronic periodontitis, to provide theoretical basis for the treatment of patients with menopausal osteoporosis and chronic periodontitis. Zoledronic acid is the third-generation bisphosphonates, is often used to treat the patients with osteoporosis malignant hypercalcemia caused by osteoporosis and bone metastasis of malignant tumor. However, it is rare to report whether zoledronic acid has curative effect to the patients with menopausal osteoporosis and chronic periodontitis. The second of the study chooses the special group with menopausal osteoporosis and chronic periodontitis as the object and finds that zoledronic acid has good curative effect to them, improves the symptoms of chronic periodontitis while improving the effect of menopausal osteoporosis. Purpose:Study the correlation between chronic periodontitis and osteoporosis in postmenopausal women as well as clinical effect of zoledronic acid to the patients with menopausal osteoporosis and chronic periodontitis.The first part involves 220 menopausal osteoporosis patients, who are from First Affiliated Hospital of Zhengzhou University and Zhangqiu Municipal People’s Hospital from January 2014 to June 2015, after examination, 58 patients are not found chronic periodontitis, as control group, 162 patients have chronic periodontitis in different severe degree, as experimental group. By bone density measuring instrument to detect bone density in order to understand the situation of osteoporosis. The periodontitis is divided into severe, moderate and mild according to the severity, and the correlation between periodontitis and bone mass level is analyzed. The second part involves 117 female patients with menopausal osteoporosis and chronic periodontitis, by random number method to divide them into experimental group 57 patients and control group 60 patients. The two groups of patients are carried out periodontal non-surgical treatment(supragingival scaling, subgingival scaling and oral health propaganda and education), the control group is given calcium carbonate 1500mg/d; the experimental group is given zoledronic acid 5mg injection and 250 ml physiological saline water intravenous injection for one time on the basis of treatment of control group, the dripping speed is not less than 15 min. After treatment, observe the two groups’ bone density, bone metabolism indexes(β-collagen fragments, N-osteocalcin and human calcitonin), clinical parameters of chronic periodontitis(gingival bleeding index, probing depth and clinical attachment loss) as well as systemic adverse reaction. Results:The experimental results of the first part show that, the bone mass level of patients with menopausal osteoporosis and chronic periodontitis: QCT value, BMC and BMD are significantly lower than what of control group, the comparison has statistical significance(P<0.05); Among them, severe chronic periodontitis group < moderate chronic periodontitis group < mild chronic periodontitis group, the comparison of groups differences has statistical significance(P<0.05); There is correlation between the incidence of osteoporosis in postmenopausal women and chronic periodontitis, and the severity of chronic periodontitis is closely related to the incidence of osteoporosis. The experimental results of the second part show that, after Method: three months of treatment, the bone density of two groups is increased, but compared with before treatment, the bone density increase difference of experimental group is significant(P<0.05); Compared experimental group with control group, β-collagen fragments(β-CTX) and N-osteocalcin(N-MID) are decreased significantly(P<0.05), calcitonin(h CT) decrease has no statistical significance(P>0.05); The gingival bleeding index(GBI), periodontal pocket probing depth(PD) and gingival attachment level(AL) of experimental group are significantly lower than what of control group(P<0.05). Conclusion:There is correlation between bone mass level of menopausal osteoporosis and the severity of chronic periodontitis, there is a positive correlation between the occurrence and development of periodontitis and menopausal osteoporosis and systemic bone mass level. Zoledronic acid has good curative effect to the patients with menopausal osteoporosis and chronic periodontitis, improves the symptoms of chronic periodontitis while improving the effect of menopausal osteoporosis.