Cultura

Osteoporosis, Oral Health, and Multidisciplinary Practice: A Narrative Review

VOLUME 23, 2026

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Sami Eid Alotaibi, Hassan Abdu Kaabi, Nourh Nawaf S. Al Zeid, Kholoud Abdulhady Alshahrani, Sultan Saleh Alzumay, Bader Shaleh Almutairi, Abdullah Miead Kahtani

Abstract

Osteoporosis is a systemic skeletal disorder characterized by reduced bone strength and increased susceptibility to fragility fractures. Although classically framed as a musculoskeletal disease, osteoporosis has important implications for oral health, laboratory diagnostics, nutrition practice, imaging workflows, nursing care, and population-level prevention. The oral cavity reflects several downstream effects of altered bone metabolism, including alveolar bone loss, tooth loss, periodontal breakdown, impaired support for prostheses and implants, and clinical challenges related to antiresorptive therapy. At the same time, oral findings may serve as practical entry points for case finding and referral in adults at elevated fracture risk. This narrative review was designed to mirror the scope and clinical orientation of existing reviews on osteoporosis and oral health while broadening the discussion for allied and technical health disciplines. The review synthesizes current knowledge on the epidemiology and pathophysiology of osteoporosis, the relationship between systemic bone loss and oral disease, the role of bone turnover markers and nutritional assessment, the value of radiologic evaluation including dual-energy X-ray absorptiometry, and the contribution of nursing and public health interventions to prevention and long-term adherence. Special attention is given to interdisciplinary workflow, because clinically meaningful prevention rarely occurs within one discipline alone. Dental professionals may identify oral manifestations or medication-related concerns; laboratory specialists may support baseline assessment and treatment monitoring through carefully interpreted biochemical markers; food and nutrition specialists can address calcium, vitamin D, protein intake, and modifiable dietary risks; nursing personnel can improve education, medication adherence, mobility safety, and care coordination; radiology staff are central to accurate densitometry acquisition and quality control; and public health practitioners can link individual detection with screening policy and fracture prevention. The available literature indicates that oral health status and bone health are related through shared biologic pathways, aging, inflammation, hormonal changes, and behavioral risk factors, although causality is not uniform across all studies. A multidisciplinary approach that integrates oral assessment, risk stratification, imaging, laboratory support, nutritional counseling, and community prevention offers the strongest framework for reducing fracture burden and preserving quality of life.

Keywords : osteoporosis; oral health; dental care; public health; nursing care; radiology..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty