Correlations between periodontitis and loss of mandibular bone in relation to systemic bone changes in postmenopausal Japanese women

Abstract

A new method of measuring mandibular alveolar bone mineral density (BMD) was applied to 40 postmenopausal Japanese women aged 50-69 years exhibiting minimal to mild periodontal diseases. Lumbar spine BMD was measured by dual X-ray absorptiometry (DXA) and calcaneus speed of sound (SOS) by quantitative ultrasound (QUS). There were age-related decreases of alveolar BMD, calcaneus SOS and vertebral BMD. There were significant correlations between two of the respective bone mass values. Correlations between clinical dental findings and bone mass data including alveolar BMD, SOS and lumbar spine BMD were investigated. Significant correlations were demonstrated between alveolar BMD and calcaneus SOS or vertebral BMD. Alveolar BMD showed significant correlation with clinical dental findings including periodontal pocket depth and mobility as well as calcaneus SOS and lumbar spine BMD. Using multivariate analysis combinations of univariate predictors, including deoxypyridinoline (DPD), significantly predicted attachment levels. The SOS value was useful combined with other predictors for predicting attachment level. It was concluded that the new method of evaluating alveolar BMD is useful to predict systemic bone mass and strength as well as dental clinical findings.

Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis

“…22,23,29,30 The correlation between mandibular BMD and other skeletal sites assessed by various techniques have also been reported. 14,15,22,[31][32][33][34] Similarly, we found significant positive correlation between mandibular and femoral BMD. However, a recent study reported that the BMD of the jaw measured using DXA was not correlated with femoral BMD.…”

“…30 The association between systemic BMD and periodontal disease has been addressed in a number of studies. 6,[9][10][11][12][13][14][15][16][17][18][19][20] While the cross-sectional studies conducted on post-menopausal osteoporotic females and elderly males suggested that there was a correlation between systemic BMD and periodontal disease, [9][10][11]14,35 other studies conducted on pre-menopausal females and young male populations did not support such a relationship. 6,12,13 A recent longitudinal study conducted on elderly Chinese males suggested that osteoporosis is associated with severe loss of clinical attachment and interproximal gingival recession.…”

“…In one study, a significant correlation was found between the alveolar BMD, which was measured using a scale on dental radiographs and periodontal pocket depth and tooth mobility. 14 The other study that assessed the BMD of the mandibular cortex using quantitative CT found a negative correlation between periodontal pocket depth and the BMD of the mandibular lingual cortex. 5 Likewise, it is not yet known whether the BMD of the jaw is lower in subjects with periodontitis than in their healthy counterparts.…”

“…8 Although the relationship between skeletal bone mineral density (BMD) and periodontitis has been extensively investigated, the results have shown varying degrees of inconsistency. 6,[9][10][11][12][13][14][15][16][17][18][19][20] In a review by Wactawski-Wende, 8 these inconsistencies were attributed to differences in sample size, the limited control of potentially confounding factors and the definitions of both periodontal disease and osteoporosis. Furthermore, only a few studies have assessed the relationship between local BMD in the jaw and periodontitis, and to our knowledge all were conducted on post-menopausal females.…”

Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis

“…11 risk groups, which may explain why conclusions on the relationship between osteoporosis and periodontitis are disputed [30][31][32][33][34]. The present study identified a strong relationship between the periodontitis and osteoporosis, and especially for the risk of a future fracture if the older person had a diagnosis of both osteoporosis and periodontitis.…”