Abstract / Summary
Hip fractures in older adults are associated with substantial morbidity and mortality, and sequential hip fractures represent a particularly vulnerable clinical condition. Although oral conditions have been suggested to influence fracture risk, most studies have focused on skeletal factors such as bone mineral density and nutritional status. The relationship between functional occlusal support and sequential hip fractures remains unclear. This study examined the association between loss of posterior occlusal support and sequential hip fractures in older adults. We conducted a retrospective study of 276 patients aged ≥ 75 years who underwent surgery for hip fracture at a single trauma center. Patients were classified into unilateral fracture ( n = 225) and sequential bilateral fracture groups ( n = 51). Occlusal status was assessed using the Eichner classification, with loss of posterior occlusal support defined as Eichner Class C, indicating complete loss of posterior occlusal supporting zones. Data on demographic characteristics, body mass index, bone mineral density, cognitive function, nutritional status, and osteoporosis treatment status were collected. Multivariable logistic regression analysis was performed to evaluate factors associated with sequential hip fractures. Patients with sequential hip fractures were significantly older and more frequently female than those with unilateral fractures. Loss of posterior occlusal support was more prevalent in the sequential fracture group. In multivariable analysis, increasing age, female sex, and loss of posterior occlusal support were associated with sequential hip fractures (Eichner Class C: OR 1.95, 95% CI 1.01–3.77). This association was attenuated after additional adjustment for cognitive function. This study suggests an association between loss of posterior occlusal support and sequential hip fractures in older adults. Loss of posterior occlusal support may reflect functional vulnerability or poor general condition in this population.