Sex hormone replacement therapy in periodontology—A systematic review

Abstract

Objective To analyse whether sex hormone replacement therapy (HRT) improves periodontal parameters and dental implants osseointegration in humans. Materials and Methods Electronic databases and hand searches were performed from June to August 2018 in SciELO, LILACS and PubMed/MEDLINE. Human observational and interventional studies that evaluated the following parameters were included: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), radiographic bone loss (RBL) or osseointegration. Results Initial search retrieved 1,282 non‐duplicated articles. Fifteen studies were selected after inclusion criteria were applied. All studies were performed in postmenopausal women. Mean differences for PPD reduction ranged from 0.02 to 0.2 mm in HRT‐positive patients; mean CAL gain −0.18 to 0.54 mm; mean RBL reduction −0.87 to 0.15 mm; and mean BOP reduction 9%‐30.3%. Failure rate of dental implants increased −5.5% to 11.21% when HRT was used. Conclusions Very low but consistent evidence suggests a reduction in BOP and no impact on RBL in postmenopausal women receiving HRT. There are inconsistent reports that suggest that HRT in postmenopausal women: (a) improves or does not impact PPD reduction and CAL gain; and (b) does not impact or increase implant loss. In summary, there is no evidence to support HRT prescription for either men or women for periodontal/implant placement purposes.

Hormone‐related events and periodontitis in women

“…A recent systematic review concluded how HRT reduces BoP and has no impact on radiographic bone levels. However, the data were inconsistent for the impact of HRT on PPD and CAL (Chaves, Figueredo, Warnavin, Pannuti, & Steffens, ).…”

Estrogen signaling impacts temporomandibular joint and periodontal disease pathology

“…Based on the National Health and Nutrition Examination Survey (NHANES III) database, there was also an association between HRT use and decreased clinical attachment loss [118]. However, a recent metaanalysis concluded that HRT in post-menopausal women did affect radiographic bone loss or clinical attachment loss [119]. A possible reason for these discordant results, comes from a recent paper that analyzed the NHANES database and found that HRT and clinical periodontal measures were strongest among women with high vitamin D levels [120].…”

Interferência da Menopausa na Osseointegração: Uma Revisão Bibliográfica / Menopause Interference with Osseointegration: A Bibliographic Review

“…A menopausa é um evento fisiológico que ocorre por volta dos 50 anos de idade devido à interrupção do ciclo menstrual e resulta em alterações hormonais irreversíveis. Ou seja, a menopausa é o encerramento da vida reprodutiva que é caracterizada pela cessação permanente da menstruação devido à perda da função ovariana (MOEINTAGHAVI et al, 2013;CHAVES et al, 2019;LINS et al, 2020).…”