Open Access Open Access  Restricted Access Subscription Access

Association between Periodontal Disease and Osteoporosis among Post-Menopausal Women


Affiliations
1 Associate Professor, Periodontics, Department of Oral Basic and Clinical Sciences, Ibn Sina National College for Medical Studies, Jeddah - 22421, Saudi Arabia
2 Associate Professor, Pediatric Dentistry, Department of Preventive Dental Sciences, Ibn Sina National College for Medical Studies, Jeddah - 22421, Saudi Arabia
3 Former Dean, Professor and Head, Department of Periodontics, Rajah Muthiah Dental College Hospital, Annamalai University, Annamalai Nagar, C. Kothangudi − 608002, Tamil Nadu, India
 

Aims: The present study was conducted to evaluate the relationship between systemic bone mineral density and periodontal status in postmenopausal women, and to evaluate the association between serum estrogen levels and periodontal status in osteoporotic post-menopausal women. Methodology: 200 postmenopausal women were subjected to systemic bone density measurements using the Achilles Express Densitometer, out of which 136 were enrolled for the study. Based on the systemic bone mineral density values obtained, the patients were divided into osteoporosis, osteopenia and non-osteoporosis groups. Plaque index, probing pocket depth, clinical attachment loss and tooth loss were recorded. Those patients who had bone mineral density values corresponding to the osteoporosis group were subjected to blood investigations to determine the serum estrogen, calcium, phosphorus and alkaline phosphatase levels. Results: Of the 136 women, 42 were in the osteoporosis group (30.9%), 66 were in the osteopenia group (48.5%) and 28 were in the nonosteoporosis group (20.5%). Age of the postmenopausal women, their plaque score, tooth loss, clinical attachment loss and probing pocket depth had a direct and significant association with osteoporosis. The osteopenia group was not statistically significant when compared to non-osteoporosis group with respect to the selected variables. No statistical significance between serum estrogen levels and any of the selected variables in the osteoporosis group was observed. Conclusion: The study confirms a significant direct association between osteoporosis and periodontitis among post-menopausal women.

Keywords

Bone Mineral Density, Osteoporosis, Periodontal Disease, Post-Menopausal Women.
User
Notifications
Font Size

  • Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B. Calcium and vitamin D supplements reduce tooth loss in the elderly. Am. J. Med. 2001; 111(6):452-56. https://doi.org/10.1016/S0002-9343(01)00899-3.
  • Gomes‐Filho IS, Passos JD, Cruz SS, Vianna MI, Cerqueira ED, Oliveira DC, et al. The association between postmenopausal osteoporosis and periodontal disease. J. Periodontol. 2007; 78(9):1731-40. https://doi.org/10.1902/jop.2007.070057. PMid: 17760543.
  • Wang CW, McCauley LK. Osteoporosis and periodontitis. Curr. Osteoporos. Rep. 2016; 14(6):284-91. https://doi.org/10.1007/s11914-016-0330-3. PMid: 27696284, PMCid: PMC5654540.
  • Aaseth J, Boivin G, Andersen O. Osteoporosis and trace elements-an overview. J. Trace. Elem. Med. Biol. 2012; 26(23):149-52. https://doi.org/10.1016/j.jtemb.2012.03.017. PMid: 22575536.
  • Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002; 359(9319):1761-67. https://doi.org/10.1016/S0140-6736(02)08657-9.
  • Black DM, Rosen CJ. Postmenopausal osteoporosis. N. Engl. J. Med. 2016; 374(3):254-62. https://doi.org/10.1056/NEJMcp1513724. PMid: 26789873.
  • NIH consensus development panel on osteoporosis prevention, diagnosis, and therapy. Osteoporosis prevention, diagnosis, and therapy. J. Am. Med. Assoc. 2001; 285(6):785-95. https://doi.org/10.1001/jama.285.6.785. PMid: 11176917.
  • Norderyd OM, Grossi SG, Machtei EE. Periodontal status of women taking postmenopausal estrogen supplementation. J. Periodontol. 1993; 64(10):957-62. https://doi.org/10.1902/jop.1993.64.10.957. PMid: 8277404.
  • Levin VA, Jiang X, Kagan R. Estrogen therapy for osteoporosis in the modern era. Osteoporos. Int. 2018; 29(5):1049-55. https://doi.org/10.1007/s00198-018-4414-z. PMid: 29520604.
  • Brown JP, Josse RG, Scientific Advisory Council of the Osteoporosis Society of Canada. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Can. Med. Assoc. J. 2002; 167(10 suppl):S1-34.
  • Shibu B, Singh AJ, Khanna T, Singh AB. Normative broadband ultrasound attenuation and speed of sound data and correlation between t-scores of quantitative ultrasound and dual energy x-ray absorptiometry among females of Manipur. Int. J. Med. Res. Health Sci. 2018; 7(6):100-04.
  • Roldan EQ, Brianese N, Raffetti E, Focà E, Pezzoli MC, Bonito A, et al. Comparison between the gold standard DXA with calcaneal Quantitative Ultrasound basedStrategy (QUS) to detect osteoporosis in an HIV infected cohort. Braz. J. Infect. Dis. 2017; 21(6):581-86. https://doi.org/10.1016/j.bjid.2017.08.003. PMid: 28950107.
  • Maria S, Witt‐Enderby PA. Melatonin effects on bone: Potential use for the prevention and treatment for osteopenia, osteoporosis, and periodontal disease and for use in bone‐grafting procedures. J. Pineal. Res. 2014; 56(2):115-25. https://doi.org/10.1111/jpi.12116. PMid: 24372640.
  • Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, et al. Executive summary: Stages of Reproductive Aging Workshop (STRAW). Fertil. Steril. 2001; 76:874-78. https://doi.org/10.1016/S0015-0282(01)02909-0.
  • Yoshihara A, Seida Y, Hanada N, Miyazaki H. A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults. J. Clin. Periodontol. 2004; 31(8):680-84. https://doi.org/10.1111/j.1600-051X.2004.00548.x. PMid: 15257747.
  • Anonymous WHO Study Group. Assessment of fracture risk and its application to screening for post-menopausal osteoporosis. WHO, Geneva; 1994.
  • Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C, Hope S, Drudge-Coates L, et al. Medication-related osteonecrosis of the jaw: Definition and best practice for prevention, diagnosis, and treatment. Oral Surg., Oral Med., Oral Pathol., Oral Radiol. 2019; 127(2):117-35. https://doi.org/10.1016/j.oooo.2018.09.008. PMid: 30393090.
  • Xu Y, Guo B, Gong J, Xu H, Bai Z. The correlation between calcaneus stiffness index calculated by QUS and total body BMD assessed by DXA in Chinese children and adolescents. J. Bone Miner Metab. 2014; 32(2):159-66. https://doi.org/10.1007/s00774-013-0474-5. PMid: 23695447.
  • Guglielmi G, de Terlizzi F. Quantitative ultrasound in the assessment of osteoporosis. European J. Radiol. 2009; 71(3):425-31. https://doi.org/10.1016/j.ejrad.2008.04.060. PMid: 19651483.
  • Vallipakorn SA, Vallipakorn O, Sophonsritsuk A, Jirapinyo M, Sritara C. The optimal cut-points for weight and nonweight quantitative ultrasound of the calcaneus to screen osteoporosis in postmenopausal women. J. Med. Assoc. Thai. 2016; 99(3):249-56.
  • Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, Davidson KW, et al. Screening for osteoporosis to prevent fractures: US preventive services task force recommendation statement. J. Am. Med. Assoc. 2018; 319(24):2521-31. https://doi.org/10.1001/jama.2018.7498. PMid: 29946735.
  • Novack DV. Estrogen and bone: osteoclasts take center stage. Cell Metab. 2007; 6(4):254-56. https://doi.org/10.1016/j.cmet.2007.09.007. PMid: 17908554.
  • Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton. Trends Endocrinol. Metab. 2012; 23(11):576-81. https://doi.org/10.1016/j.tem.2012.03.008. PMid: 22595550, PMCid: PMC3424385.
  • Jeyakumar M, Carlson KE, Gunther JR, Katzenellenbogen JA. Exploration of dimensions of estrogen potency parsing ligand binding and coactivator binding affinities. J. Biol. Chem. 2011; 286(15):12971-82. https://doi.org/10.1074/jbc.M110.205112. PMid: 21321128, PMCid: PMC3075970.
  • Ohlsson C, Vandenput L. The role of estrogens for male bone health. Eur. J. Endocrinol. 2009; 160(6):883-89. https://doi.org/10.1530/EJE-09-0118. PMid: 19304870.
  • Lane NE. Epidemiology, etiology, and diagnosis of osteoporosis. Am. J. obstet. Gynecol. 2006; 194(2):S3-11. https://doi.org/10.1016/j.ajog.2005.08.047. PMid: 16448873.
  • Nair SP, Wilson M, Reddi K, White P, Henderson B. Bacterially induce bone destruction: Mechanisms and misconceptions. Infect Immun. 1996; 64(7):2371-80. https://doi.org/10.1128/IAI.64.7.2371-2380.1996. PMid: 8698454, PMCid: PMC174085.
  • Payne JB, Zachs NR, Reinhardt RA, Nummikoski PV, Patil K. The association between estrogen status and alveolar bone density changes in postmenopausal women with a history of periodontitis. J. Periodontol. 1997; 68(1):24-31. https://doi.org/10.1902/jop.1997.68.1.24. PMid: 9029448.
  • Du Z, Steck R, Doan N, Woodruff MA, Ivanovski S, Xiao Y. Estrogen deficiency-associated bone loss in the maxilla: A methodology to quantify the changes in the maxillary intra-radicular alveolar bone in an ovariectomized rat osteoporosis model. Tissue Engineering Part C: Methods. 2015; 21(5):458-66. https://doi.org/10.1089/ten.tec.2014.0268. PMid: 25315176.
  • Von Wowern N, Klausen B, Kollerup G. Osteoporosis: A risk factor in periodontal disease. J. Periodontol. 1994; 65(12):1134-38. https://doi.org/10.1902/jop.1994.65.12.1134. PMid: 7877085.
  • Manjunath SH, Rakhewar P, Nahar P, Tambe V, Gabhane M, Kharde A. Evaluation of the prevalence and severity of periodontal diseases between osteoporotic and nonosteoporotic subjects: A cross-sectional comparative study. J. Contemp. Dent. Pract. 2019; 20(10):12-23. https://doi.org/10.5005/jp-journals-10024-2717. PMid: 31883261.
  • Pilgram TK, Hildebolt CF, Yokoyama-Crothers N, Dotson M, Cohen SC, Hauser JF, et al. Relationships between longitudinal changes in radiographic alveolar bone height and probing depth measurements: Data from postmenopausal women. J. Periodontol 1999; 70(8):82933. https://doi.org/10.1902/jop.1999.70.8.829. PMid: 10476888.
  • Weyant RJ, Pearlstein ME, Churak AP, Forrest K, Famili P, Cauley JA. The association between osteopenia and periodontal attachment loss in older women. J. Periodontol. 1999; 70(9):982-91. https://doi.org/10.1902/jop.1999.70.9.982. PMid: 10505800.
  • Elders PJ, Habets LL, Netelenbos JC, van der Linden LW, van der Stelt PF. The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age. J. Clin. Periodontol. 1992; 19(7):492-96. https://doi.org/10.1111/j.1600-051X.1992.tb01162.x. PMid: 1430285.
  • Martinez-Maestre MA, Gonzalez-Cejudo C, Machuca G, Torrejon R, Castelo-Branco C. Periodontitis and osteoporosis: A systematic review. Climacteric. 2010; 13(6):523-29. https://doi.org/10.3109/13697137.2010.500749. PMid: 20690866.
  • Klemetti E, Collin HL, Forss H, Markkanen H, Lassila V. Mineral status of skeleton and advanced periodontal disease. J. Clin. Periodontol. 1994; 21(3):184-88. https://doi.org/10.1111/j.1600-051X.1994.tb00301.x. PMid: 8157771.
  • Taguchi A, Tanimoto K, Suei Y, Otani K, Wada T. Oral signs as indicators of possible osteoporosis in elderly women. Oral Surg., Oral Med., Oral Pathol., Oral Radiol., Endodontol. 1995; 80(5):612-16. https://doi.org/10.1016/S1079-2104(05)80158-1.
  • Yoshihara A, Seida Y, Hanada N, Nakashima K, Miyazaki H. The relationship between bone mineral density and the number of remaining teeth in community‐dwelling older adults. J. Oral Rehabil. 2005; 32(10):735-40. https://doi.org/10.1111/j.1365-2842.2005.01491.x. PMid: 16159351.
  • Bodic F, Hamel L, Lerouxel E, Baslé MF, Chappard D. Bone loss and teeth. Joint Bone Spine. 2005; 72(3):215-21. https://doi.org/10.1016/j.jbspin.2004.03.007. PMid: 15850992.
  • Mohammad AR, Bauer RL, Yeh CK. Spinal bone density and tooth loss in a cohort of postmenopausal women. Int. J. Prosthodont. 1997; 10(4):381-85.

Abstract Views: 1

PDF Views: 2




  • Association between Periodontal Disease and Osteoporosis among Post-Menopausal Women

Abstract Views: 1  |  PDF Views: 2

Authors

Prathibha Anand Nayak
Associate Professor, Periodontics, Department of Oral Basic and Clinical Sciences, Ibn Sina National College for Medical Studies, Jeddah - 22421, Saudi Arabia
Ullal Anand Nayak
Associate Professor, Pediatric Dentistry, Department of Preventive Dental Sciences, Ibn Sina National College for Medical Studies, Jeddah - 22421, Saudi Arabia
Mythili R.
Former Dean, Professor and Head, Department of Periodontics, Rajah Muthiah Dental College Hospital, Annamalai University, Annamalai Nagar, C. Kothangudi − 608002, Tamil Nadu, India

Abstract


Aims: The present study was conducted to evaluate the relationship between systemic bone mineral density and periodontal status in postmenopausal women, and to evaluate the association between serum estrogen levels and periodontal status in osteoporotic post-menopausal women. Methodology: 200 postmenopausal women were subjected to systemic bone density measurements using the Achilles Express Densitometer, out of which 136 were enrolled for the study. Based on the systemic bone mineral density values obtained, the patients were divided into osteoporosis, osteopenia and non-osteoporosis groups. Plaque index, probing pocket depth, clinical attachment loss and tooth loss were recorded. Those patients who had bone mineral density values corresponding to the osteoporosis group were subjected to blood investigations to determine the serum estrogen, calcium, phosphorus and alkaline phosphatase levels. Results: Of the 136 women, 42 were in the osteoporosis group (30.9%), 66 were in the osteopenia group (48.5%) and 28 were in the nonosteoporosis group (20.5%). Age of the postmenopausal women, their plaque score, tooth loss, clinical attachment loss and probing pocket depth had a direct and significant association with osteoporosis. The osteopenia group was not statistically significant when compared to non-osteoporosis group with respect to the selected variables. No statistical significance between serum estrogen levels and any of the selected variables in the osteoporosis group was observed. Conclusion: The study confirms a significant direct association between osteoporosis and periodontitis among post-menopausal women.

Keywords


Bone Mineral Density, Osteoporosis, Periodontal Disease, Post-Menopausal Women.

References





DOI: https://doi.org/10.18311/ajprhc%2F2020%2F25109