Association between periodontal disease and bone mineral density in postmenopausal women: A cross sectional study

Abstract

Objectives: Both periodontitis and osteoporosis represent major health problems especially in elderly women. The relationship between the two diseases and oral bone loss is important having significant public health impact in the prevention of morbidity and mortality related to these disorders. The present study was aimed to investigate the possible association between osteoporosis and periodontal disease among postmenopausal women residing in Goa, India. Study design: A complete periodontal examination (all teeth except third molar) including plaque index (PI), gingival index (GI), clinical attachment loss (CAL) measurement was performed on 80 dentate Goan postmenopausal women (age ≥ 50 yrs) with generalized chronic periodontitis. Mean alveolar bone loss (ABL) was measured from full mouth intraoral periapical radiographs, by recording the distance from cementoenamel junction (CEJ) and the most coronal portion of alveolar crest at mesial and distal aspect of all teeth except canines and third molars. Systemic bone loss was determined from hand-wrist radiograph of the patient through Digital X-Ray Radiogrammetry. Statistical analysis was done to assess the relationships between periodontal variables and bone mineral density (BMD) after adjusting for age, years since menopause, body mass index (BMI), smoking, number of remaining teeth, PI and GI. Results: Age of the patient, years since menopause and BMI showed significant correlation with BMD. CAL and ABL showed mildly negative and statistically nonsignificant correlation with the BMD. Of all the variables studied, only smoking and BMI were strong predictors of BMD. Conclusion: Skeletal BMD is related to interproximal ABL and CAL, though not to a statistically significant level; implicating postmenopausal osteopenia as a risk indicator for periodontal disease.

Initial changes in alveolar bone volume for sham-operated and ovariectomized rats in ligature-induced experimental periodontitis

“…The results from this study demonstrated that a significant negative correlation was observed between periodontal disease and truncal bone BMD further confirming the relationship between osteoporosis and periodontal disease [13]. Further research groups studying populations from Jordan [12], India [9], and USA [11] demonstrate various relationships between periodontal disease and osteoporosis. Noteworthy, while a positive correlation is observed in some studies, other studies have failed to demonstrate either a relationship exists or have concluded that osteoporosis is not a causal factor in the development of moderate to severe chronic periodontitis [15,16].…”

“…Interestingly, growing clinical evidence has suggested that a relationship between osteoporosis and periodontal disease exist [8][9][10][11][12][13][14]. In one of the first well-documented studies investigating this relationship, it was found that osteoporosis had no significant effect with respect to plaque and gingival bleeding but was associated with a significantly greater loss of attachment in osteoporotic women [10].…”

Influence of different durations of estrogen deficiency on alveolar bone loss in rats

“…The deficiency of sex steroids, particularly estrogen, is considered to be the main cause of osteoporosis, although there are many other factors involved. 15 Few studies exist that evaluate the relationship between estrogen deficiency and periodontal disease associated with bone loss in rats. 9,10 Thus, the aim of this study was to morphometrically evaluate the influence of different durations of estrogen deficiency on the ligature-induced alveolar bone loss.…”

Assessment the Relationship between Osteoporosis with Tooth Loss and Dry Mouth in Women with Osteoporosis

“…On the other hand, hormonal changes during this period causes women become more susceptible to inflammatory diseases of the supporting tissues of the teeth; especially, if she doesn't regard the oral health, the risk of this disease will increase [8]. Sultan [9] showed in his studies that relation between bone density loss and bone cavity erosion, indicates that loss of bone mass during menopause have been as a serious factor for periodontal disease [9].…”