Читать книгу Bone and Soft Tissue Augmentation in Implantology - Группа авторов - Страница 33

Among general medical conditions, diseases with a direct impact on bone metabolism are still the greatest risk group for implant therapy, especially in combination with bone grafting. Most patients in western society do not exercise enough and many of them suffer from degeneration of the skeletal system, especially due to hormonal changes and advanced age. Today, osteoporosis is considered to be one of the most severe diseases, with the risk of life-threatening vertebral body factors³⁵ (Fig 2-4a). Hints that the blood levels of cholecalciferol (vitamin D) is low are soft bone structures in preoperative radiographs or increased bone resorption.¹⁹ In such cases, medication is administered, which is specified in three different stages.³⁶ The least risky and most beneficial for implant placement consists of calcium and vitamin D supplements. Newer drug approaches follow the application of strontium preparations, which have a positive effect on bone metabolism, as bone resorption is inhibited, and the formation of new bone is promoted. In such instances, however, negative phenomena can occur in the area of the oral mucosa, which can then lead to peri-implant mucosal changes if the medication continues (Fig 2-4b).

Fig 2-4a Densitometry in case of osteoporosis with below-average bone density values in the area of the spine.