Oral bone loss

Surgical treatments for oral bone loss alone were estimated to cost in the vicinity of 5- 6 billion per year af leasf 5 years ago, an amoimt that does not include the costs associated with impaired dentition due to tooth loss (Hildebolt, 2007). The potential associated psychological, social, and physical harm that may have to be endured was also not considered. Therefore, if seems prudenf fo ensure fhaf one s diefary infake of bioavail-able Ca is adequate to avoid at least one potentially modifiable risk facfor for foofh loss. 

Hildebolt, C. F. Oral bone loss assessment and repair. Available from http //research, medicine. wustl.edu/ocfr/Resear ch.nsf/s/B4883B6A205D60BA8625677D00592BBC [Accessed March 2007]. 

Golub LM, Ramamurthy NS, Llavaneras A, Ryan ME, Lee HM, Liu Y, Bain S, Sorsa T. A chemicaUy modified nonantimicrobial tetracycline (CMT-8) mhibits gmgival matrix metalloproteinases, periodontal breakdovm, and extra-oral bone loss in ovariectomized rats. Ann NY Acad Sci 1999 878 290-310. 

Patients with IBD, particularly those with CD, are also at risk for bone loss. This may be a function of malabsorption or an effect of repeated courses of corticosteroids. Patients with IBD should receive a baseline bone density measurement prior to receiving corticosteroids. Vitamin D and calcium supplementation should be used in all patients receiving long-term corticosteroids. Oral bisphosphonate therapy may also be considered in patients receiving prolonged courses of corticosteroids or in those with osteopenia or osteoporosis. 

TAS-108 (SR16234) is a novel and orally active steroidal compound with a proposed additional molecular mode-of-action that is different from that of SERMs such as tamoxifen and raloxifene [157]. TAS-108 is a full estrogen receptor-a antagonist, and it should also recruit co-activator transcriptional intermediary factor 2 to ER-j6, which may have a preventive effect on bone loss [157]. 

Accelerated bone loss, with an increased risk of first hip fracture, occurred in elderly women taking oral glucocorticoids (201). At baseline, 122 (1.5%) women were taking inhaled glucocorticoids only (median dose equivalent to... 

The efficacy of clodronate in treating glucocorticoid-induced bone loss in asthmatic subjects has been evaluated in a double-blind study in 74 adults (41 women and 33 men, mean age 57 years) with a long history (mean 8.1 years) of oral and inhaled glucocorticoid use, randomized to clodronate 800,1600, or 2400 mg/day or placebo (130). There was no increase in bone mineral density with placebo or clodronate 800 mg/day, but a significant dose-related increase with clodronate 1600 and 2400 mg/day. The most common adverse effect was gastric irritation in the patients who took the highest dose of clodronate. 

A 2-year randomized controlled study in 90 women compared the effects of oral tibolone doses of 1.25 mg/day and 2.5 mg/day on bone loss in the early postmenopausal period all took calcium 1000 mg/day. Vertebral and femoral bone density rose in both treated groups but fell in the control group, and bone turnover markers (urinary excretion of hydroxyproline/creatinine and plasma osteocalcin concentrations) were similarly affected favorably in the treated groups, as was the incidence of hot flushes/ flashes (5). Studies such as this still leave open the question of the advisability of continuing tibolone treatment over a longer period. While tibolone has indeed been shown to benefit mineral bone density, few data are available to show whether it lowers fracture incidence nor is it clear whether there is a link between tibolone and breast cancer (6). 

Anderson, J.J., Ambrose, W.W., and Gamer, S.C. 1995a. Orally dosed genistein from soy and prevention of cancellous bone loss in two ovariectomized rat models. J. Nutr. 125, 799s. 

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