Copper deficit as a potential pathogenic factor of

Authors: T Sierpinska J Konstantynowicz K Orywal M Golebiewska M Szmitkowski

Publish Date: 2013/06/25

Volume: 25, Issue: 2, Pages: 447-454

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Abstract

The study evaluated if men and women with severe tooth wear were at increased risk of general bone loss Enamel biopsies obtained from 50 subjects aged 475 ± 5 years showed decreased copper content which was associated with reduced spine bone mineral density suggesting deficits of this trace element contributing to bone demineralization enamel attrition and deteriorated quality of mineralized tissuesThe objective of this crosssectional study was to assess associations between enamel trace minerals and bone mineral density BMD in severe tooth wear We hypothesized that similar factors contributed to both the excessive abrasion of dental enamel and reduced BMD in subjects with tooth wearFifty patients aged 475 ± 5 years with severe tooth wear and 20 age sex and body mass index BMImatched healthy volunteers with normal dental status were studied regarding dietary intakes of trace elements serum and salivary copper Cu zinc Zn and calcium Ca concentrations and serum PTH osteocalcin and hydroxyvitamin D levels Tooth wear was determined using clinical examination based on standard protocol according to Smith and Knight In all subjects acid biopsies of the maxillary central incisors were carried out to assess mineral composition of the enamel Atomic absorption spectroscopy with an air/acetylene flame was used to measure Ca and Zn and graphite furnace atomic absorption spectroscopy was used to analyze Cu content BMD was examined using dual energy Xray absorptiometryTooth wear patients had reduced lumbar spine but not femoral BMD relative to controls p  0001 No differences were found in enamel Ca concentration and Zn content was slightly higher in tooth wear patients than in controls whereas Cu content was significantly decreased in the patients 1959 ± 164 vs 3686 ± 261 μg/l p = 001 despite similar levels of Cu in serum and saliva The differences were independent of serum 25OHD osteocalcin concentrations or PTH eitherSevere tooth wear is associated with reduced spinal BMD Enamel in adult individuals with severe tooth wear is low in copper content Therefore further work is needed to determine whether copper plays a role in bone pathophysiology in these patientsTeeth and bones are regarded the most mineralized tissues in humans Several reports suggest association between tooth loss or small number of remaining teeth and reduced bone mineral density BMD 1 2 3 4 5 There is also evidence of the effect of periodontal disease and osteoporosis in the elderly 6 7 8 9 10 11 Furthermore periodontal disease has also been reported an important and common coincidence of systemic bone loss in both women and men 12 13 14 15 16 It has been shown that the reduction of systemic BMD may be a risk factor for the development of tooth loss and oral health problems 2 7 17 suggesting possible cause–effect link particularly in postmenopausal women with osteoporosis 13 18 19 Some studies also show that dental status impairment related to osteoporosis may result from a considerable decrease of mandibular bone mass 20 21 though the contributing factors remain unclear Possible mechanisms may include tooth loss during ageing as a natural process secondary to the systemic bone loss however the agerelated progressive dental decline may also coexist with deficits in BMD 17 21 These associations are well recognized among the elderly but there are still limited data on such associations in younger age Accelerated tooth wear appears one of the conditions affecting enamel independently of age so that it may occur in younger otherwise healthy peopleIt is well known that tooth enamel is the hardest tissue in the human body Although enamel does not have the typical structure of human bone its chemical composition is similar Hydroxyapatite and magnesium phosphate are building minerals essential for bone structure quality and resistance whereas some trace elements ie zinc and copper are very important for bone integrity and elasticity Enamel is continuously affected by the process of wear Although the tooth wear is recognized the physiological and irreversible phenomenon there are individuals in whom this process of wear occurs dramatically faster and if not treated may lead to the complete destruction of stomatognathic system 22 The cause of this acceleration of tooth wear is multifactorial as it is generally a combination of abrasion attrition and erosion 23 Thus the processes of local demineralization and remineralization reflecting the erosionattrition or erosionabrasion play the key role in the clinical picture of wear 24 25 26 27

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