Assessment of osteoporotic alterations in achondroplastic patients: a case series

Abstract

Achondroplasia (ACH) is the most common form of human dwarfism and has been associated with biochemical alterations of the bone tissue, also observed in cases of osteoporosis. The present case series aimed at assessing low bone density, diagnosed with spinal bone mineral density (BMD) analysis and with panoramic radiograph measurements, in ACH patients. Spinal BMD was measured by means of dual-energy X-ray absorptiometry at the lumbar region (L1-L4). On dental panoramic radiographs of the patients, the mandibular cortical width was measured separately on the right and left sides. The Klemetti Index was also assigned as appropriate for evaluating the cortical area below the mandibular foramen. Additional parameters such as patient age, gender, body mass index, and number of teeth were also recorded. BMD results showed that 5/11 cases presented with skeletal osteopenia/osteoporosis diagnoses. Additionally, mandibular cortical erosion was detected in panoramic radiographs in 8/11 cases. The BMD and panoramic radiographic alterations found in this study suggest that the diagnosis of low bone density may have a special clinical relevance in cases of bone tissue disorders, such as achondroplasia.

Low bone mineral density in achondroplasia and hypochondroplasia

“…6 Taşoğlu et al also reported on a case of ACH associated with low BMD. 7 Both case series, however, described bone mass in adult ACH patients.…”

“…6,7 The purpose of this study was therefore to examine BMD in ACH/HCH patients and the discuss clinical relevance of osteoporotic alterations of these disorders.…”

Current knowledge of medical complications in adults with achondroplasia: A scoping review

“…Two small studies, of 10 and 11 adults, respectively, found reduced bone density measured by dual X‐ray absorptiometry …”

Sensitivity and Specificity of Radiographic Methods for Predicting Insertion Torque of Dental Implants

“…1A and 1E). The mandibular cortical shape index (MCI) was assessed by evaluating the appearance of the cortical bone below the mandibular foramen, using a previously described classification 32 . Briefly, the inferior mandibular cortex was classified as follows: C1 = normal (Fig.…”

“…2) at the point at which the sum of specificity and sensitivity is maximum, and equal weight is given to both 36 . For MCI, the C1 category was selected as the cutoff point because this is the only category representing the absence of alterations in the inferior mandibular cortex 32 . Finally, a peak IT of 35 Ncm was chosen as the cutoff point because this is a value recommended for immediate loading using the implant system of the present study 37,38…”