探索口腔健康與骨密度關係──環口X光片在成人的應用

Exploring the relationship between oral health and bone density: utilizing panoramic radiography in adults

目標：骨質疏鬆症患者易有其他併發症，需在骨質缺乏初期即早介入，預防疾病發展。本研究目標使用牙科常規檢查常用的環口X光片，探討其與骨密度之間的關係，可做為簡易的骨密度篩檢工具。方法：本研究為橫斷性研究，於衛生福利部朴子醫院牙科門診，招募35歲至80歲的成人參加，收集受試者病史、股骨頸骨密度、環口X光片、咀嚼力檢測、台灣版老人口腔健康評估（GOHAI）量表、牙菌斑指數、身高、體重、抽血的血鈣資料和24小時飲食回憶紀錄，使用線性、邏輯斯迴歸進行統計分析。結果：226位參與者平均年齡65.6歲，其中女性佔58.4%，男性、咀嚼力好、GOHAI分數高與下顎下緣皮質骨厚度有顯著正相關；年輕、GOHAI分數高與下顎皮質指數C3有顯著負相關；在校正心臟疾病和骨折病史後，年輕、下顎下緣皮質骨厚度較厚、下顎皮質指數C1、身體質量指數較高、血鈣濃度較高者，與股骨頸骨密度有顯著正相關。結論：利用可近性高、省時簡便的方法，於一般牙科檢查時，分析環口X光片，可即時發現骨密度低下的可能，讓民眾能提高警覺，再進一步至醫療院所進行更精密的檢查。

Objectives: Early detection of bone loss is an effective strategy for preventing osteoporosis. In this study, we used routine dental panoramic radiography to examine the relationship between oral health and bone mineral density (BMD) and ultimately establish panoramic radiography as a useful screening tool for BMD. Methods: A total of 226 patients (35–80 years of age, mean age: 65.6 years) receiving treatment at Puzi Hospital were included in this cross-sectional study. Data were collected on the patients’medical history, BMD of the femoral neck, panoramic radiography results, masticatory test results, Geriatric Oral Health Assessment Index (GOHAI) scores, plaque index, body mass index (BMI), serum calcium levels, and 24-hour dietary recall. Linear regression, and logistic regression analyses were conducted. Results: Being male and having a high GOHAI score were significantly and positively associated with mandibular cortical thickness but significantly negatively associated with mandibular cortical index C3. After adjusting for heart disease and bone fracture history, young adult, wider mandibular cortical thickness and index C1, high BMI, and high serum calcium were all found to be significantly positively associated with BMD of the femoral neck. Conclusions: Panoramic radiography is highly accessible and convenient and enables the timely detection of potential bone loss, thereby encouraging individuals to become more vigilant and willing to undergo more detailed examinations.