الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Evaluation of mandibular bone quality and quantity is markedly important for treatment planning of dental implant procedures. One of the complications associated with DM is decrease in BMD. Therefore, the quantification of BMD for these patients before a dental implant procedure is essential.
This study aimed at the evaluation of mandibular BMD as measured by CBCT and its correlation to skeletal BMD expressed in terms of T- score as assessed by DEXA, in relation to blood glycemic control assessed by HbA1c, in T2DM patients.
This study was conducted clinically on 24 cases; 18 patients were having T2DM, and 6 control patients without T2DM. All cases were referred for CBCT examination as a part of implant planning procedure. The entire study sample was subjected to blood sampling to determine HbA1c values. According to the HbA1c level, the patients were classified into four groups; group A: non-diabetic individuals (control group), group B: Individuals with well-controlled T2DM, group C: Moderately controlled T2DM patients, group D: Poorly controlled T2DM patients. Then, the patients underwent radiographic evaluation in terms of CBCT and DEXA scans.
Regarding mandibular CBCT scans, the following measurements were taken: trabecular bone density, alveolar ridge height and bucco-lingual width. These measurements were obtained using the cross-sectional cut at the middle of the posterior edentulous area representing each missing tooth within the bounded saddle. On the opposite side of the mandible, trabecular bone density was obtained at the cross sectional cut between two adjacent posterior teeth.
Concerning DEXA scans, BMD was measured at lumber spine, femoral neck and distal forearm. Spine and femoral BMD for each subject were expressed in terms of T-scores. Patients were defined as being either normal or osteopenic or osteoporotic on the basis of the lower of any of the two T-scores.
Study results indicated a statistically significant negative correlation between HbA1c values and BMD variables including: T-score values measured by DEXA, mandibular edentulous and dentate quads BMD measured by CBCT. Additionally, there was a statistically significant positive correlation between T-score values in relation to mandibular edentulous and dentate quads BMD values. However, there was no statistically significant correlation between HbA1c values and mandibular linear measurements including: alveolar ridge height and bucco-lingual width.
from the current study, we concluded that, osteoporosis can be predicted using CBCT, so it’s the oral radiologist responsibility to refer osteoporotic patients once being suspected. Additionally, good metabolic control is essential to prevent osteoporosis in diabetic patients.