Comparison of panoramic mandibular cortical bone quality indexes in amlodipine users and healthy individuals

https://doi.org/10.22146/majkedgiind.48490

Aga Satria Nurrachman(1*), Lusi Epsilawati(2), Azhari Azhari(3), Suhardjo Sitam(4)

(1) Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java
(2) Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, West Java
(3) Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, West Java
(4) Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, West Java
(*) Corresponding Author

Abstract


Hypertension and osteoporosis are believed to be linked to to each other. Previous studies have suggested that the imbalance of calcium metabolism in hypertensive condition and the use of calcium channel blockers such as amlodipine may lower the density and quality of bone. Panoramic radiography has been widely used as a reliable tool in assessing bone quality. One indicator of bone quality in panoramic radiograph is the macrostructure evaluation of mandibular cortical bone by using various indexes such as mandibular cortical index (MCI) and antegonial index (AI). This research aimed to compare the bone quality of hypertensive patients with amlodipine and healthy individuals using MCI and AI. In this study we used sixty panoramic radiographs of hypertensive patients with amlodipine and healthy individuals, thirty for each group, with various aspects of demography. The MCI analysis was done by dividing the mandibular cortical shape into three different qualitative categories and the AI analysis was done quantitatively by measuring the width of mandibular cortical bone in antegonial region using ImageJ software. There were statistically significant differences in the results between the two groups in terms of both AI (p = 0.000) and MCI (p = 0.001) in which hypertensive group had lower score. Based on this research, there were differences of mandibular bone quality of hypertensive patients with amlodipine and healthy individuals, particularly in its macrostructure.


Keywords


amlodipine; cortical bone; hypertension; mandible; radiography

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References

1. Hussein MK, Fatah AA. The effect of hypertension and beta-blocker antihypertensive
drug on bone mineral density value at the mandibular cortex in mental and gonial
regions in hounsfield unite using computed tomographic study. Journal of Al Rafidain Univ
Coll. 2016; (38): 33–47.

2. Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet. 2012;
380(9841): 611–619. doi: 10.1016/S0140-6736(12)60861-7

3. NIHRD. National Institute of Health Research and Development, Ministry of Health,
Republic of Indonesia, Jakarta. Kementerian Kesehatan RI. 2018.

4. Yang S, Nguyen ND, Center JR, Eisman JA, Nguyen TV. Association between hypertension
and fragility fracture: a longitudinal study. Osteoporos Int. 2014; 25(1): 97–103.
doi: 10.1007/s00198-013-2457-8

5. Salam MHA. Effect of blocking L-Type calcium channels on bone in ovariectomy model of
osteoporosis in rats. Med J Cairo Univ. 2017; 85(5): 1903–1910.

6. Kang KY, Kang Y, Kim M, Kim Y, Yi H, Kim J, Jung HR, Park SW, Kim HY, Ju JH, Hong
YS. The effects of antihypertensive drugs on bone mineral density in ovariectomized mice.
J Korean Med Sci. 2013; 28: 1139–1144. doi: 10.3346/jkms.2013.28.8.1139

7. Alegantina S, Isnawati A. Profil disolusi tablet amlodipin dan perbandingan kadar dua
produk generik dengan produk inovator. J Kefarmasian Indones. 2015; 5(1): 11–18.
doi: 10.22435/jki.v5i1.4081.11-18

8. Septiana F, Epsilawati L, Suhardjo, Dananjaya A. Analysis of the mandible cortical bone
height in amlodipine user patient using panoramic radiograph. FDI-PDGI Contin
Educ. 2017; 391–397.

9. Gradošová I, Živná H, Švejkovská K, Palička V, Tichý A, Živný P. Effects of amlodipine
on bone metabolism in male albino Wistar rats Cardiovascular diseases are one of
the leading causes of death for people in developed countries world-wide. The most
common form is arterial hypertension, which can be reduced by sever. Acta Vet Brno.
2011; 80: 391–396.

10. Govindraju P, Chandra P. Radiomorphometric indices of the mandible – an indicator of
osteoporosis. J Clin Diagn Res. 2014; 8(3): 195–198. doi: 10.7860/JCDR/2014/6844.4160

11. Hastar E, Yilmaz HH, Orhan H. Evaluation of mental index, mandibular cortical index and panoramic mandibular index on dental panoramic radiographs in the elderly. Eur J
Dent. 2011; 5(1): 60–67.

12. Dagistan S, Bilge OM. Comparison of antegonial index, mental index, panoramic
mandibular index and mandibular cortical index values in the panoramic radiographs of normal
males and male patients with osteoporosis. Dentomaxillofacial Radiol. 2010; 39(5): 290–294. doi: 10.1259/dmfr/46589325

13. Tofangchiha M, Javadi A, Khorasani M, Shokrimozhdehi M. Diagnosis of osteoporosis
using cortex mandibular indices based on cortex thickness and morphology in comparison
with visual assessment of the cortex. Journal of Craniomaxillofacial Research. 2017; 4(2):
345–351.

14. Moeintaghavi A, Hosseinizarch H, Tabassi SM. The comparison of mandibular radiomorphometric indices in panoramic radiography between patients with chronic periodontitis and healthy individuals. The Journal of Contemporary Dental Practice. 2014; 15(4): 461–465. doi: 10.5005/jp-journals-10024-1563

15. Carmo JZB, Medeiros SF de. Mandibular inferior cortex erosion on dental panoramic
radiograph as a sign of low bone mineral density in postmenopausal women. Rev Bras
Ginecol Obstet. 2017; 39(12): 663–669. doi: 10.1055/s-0037-1606622

16. Alapati S, Reddy RS, Tatapudi R, Kotha R, Bodu NK, Chennoju S. Identifying risk
groups for osteoporosis by digital panoramic radiography. Contemp Clincal Dent. 2015; 6(1):
253–257. doi: 10.4103/0976-237X.166833

17. Wong SK, Chin K, Suhaimi FH, Ahmad F, Ima-Nirwana S. The Relationship between
Metabolic Syndrome and Osteoporosis: A Review. Nutrients. 2016; 8(6): 347.
doi: 10.3390/nu8060347

18. Zivna H, Gradošová I, Zivny P, Cermakova E, Palicka V. Effects of Amlodipine on Bone
Metabolism in Orchidectomised Spontaneously Hypertensive Rats. Pharmacology. 2018;
102(1-2): 67–73. doi: 10.1159/000489666

19. Adelaja A, Ghazali O, Ayantunji L, Omotoso G. Amlodipine besylate impairs the morphology
of bone marrow in adult male wistar rats. Anatomy Journal of Africa. 2017; 6(2): 963–968. doi: 10.4314/aja.v6i2.160479

20. Moraes RB, Corrêa L, Luz JGC. Adverse effects of the amlodipine on bone healing of
the mandibular fracture : an experimental study in rats. Oral Maxillofac Surg. 2011; 15(2):
93–101. doi: 10.1007/s10006-010-0237-6

21. Ag˘açayak KS, Güven S, Koparal M, Güneş N, Atalay Y, Atılgan S. Long-term effects of
antihypertensive medications on bone mineral density in men older than 55 years. Clin Interv
Aging. 2014; 9: 509–513. doi: 10.2147/CIA.S60669

22. Varma B, David AP, Kurup S, Sam DM, Aravind M, Chandy ML. Assessment of panoramic
radiomorphometric indices of mandible in diabetes mellitus patients and non diabetic individuals. Journal of Clinical and Diagnostic Research. 2017; 11(11): 35–39.

23. Gunawan G, Sitam S, Epsilawati L. Densitas tulang mandibula pengguna obat anti
hipertensi calcium channel blocker (CCB) melalui radiograf panoramik. Jurnal Radiologi
Dentomaksilofasial Indonesia. 2020; 4(2): 1. doi: 10.32793/jrdi.v4i2.527

24. Septina F, Sitam S, Epsilawati L. Analisis antegonion indeks dan mental indeks pada
subjek hipertensi pengguna amlodipine yang di evaluasi menggunakan radiograf panoramik.
E-Prodenta J Dent. 2020; 4(1): 284–292.

25. Gribbin J, Hubbard R, Gladman J, Smith C, Lewis S. Risk of falls associated with
antihypertensive medication: self-controlled case series. Pharmacoepidemiol Drug Saf
[Internet]. 2011; 20(8): 879–84. doi: 10.1002/pds.2176

26. Pinheiro M de M, Eis SR. Epidemiology of osteoporotic fractures in Brazil: What we
have and what we need. Arq Bras Endocrinol Metabol. 2010; 54(2): 164–170.
doi: 10.1590/S0004-27302010000200012

27. Kim SY, Kim S, Choi SE, Kim BS, Choi HR, Hwang D, Won CW. Number of daily antihypertensive drugs and the risk of osteoporotic fractures in older hypertensive
adults: National health insurance service – Senior cohort. J Cardiol. 2017; 70(1): 80–5.
doi: 10.1016/j.jjcc.2016.09.011

28. Zaheer S, Boer I De, Allison M, Brown JM, Psaty BM, Robinson-cohen C, et al.
Parathyroid hormone and the use of diuretics and calcium-channel blockers: the multiethnic
study of atherosclerosis. J Bone Miner Res. 2016; 31(6): 1137–1145.
doi: 10.1002/jbmr.2779

29. Mao Y, Jiang L, Yan X, Ma H. Effects of antihypertensive drugs on bone metabolism in
ovariectomized spontaneously hypertensive rats. Int J Clin Exp Med. 2016; 9(9):
17628–17635.

30. Ghosh M, Majumdar SR. Antihypertensive medications, bone mineral density, and fractures: a review of old cardiac drugs that provides new insights into osteoporosis. Endocrine. 2014; 46(3): 397–405. doi: 10.1007/s12020-014-0167-4



DOI: https://doi.org/10.22146/majkedgiind.48490

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