The present study was designed to determine the threshold pressure value to be applied in provoking bleeding on probing (BOP) in clinically healthy gingival units. 12 female dental hygiene students volunteered for the study. They were selected on the basis of excellent oral hygiene standards, absence of probing depths greater than 3 mm and absence of caries or dental restorations on smooth and proximal tooth surfaces. Applying a probing force of 0.25, 0.5, 0.75 and 1.0 N in one of the 4 jaw quadrants, respectively, on 2 different occasions with an interval of 10 days, bleeding on probing was assessed. Oral hygiene and gingival conditions were determined using the criteria of the plaque control record and the gingival index. On the basis of the BOP values, obtained using the lowest probing force (0.25 N), the subjects were divided into 2 groups: group 1 ("minimal BOP" value) consisted of 6 subjects yielding practically no bleeding (mean BOP = 0.9%) at both examinations, while the subjects of group 2 ("low BOP" value) had slightly higher BOP% (mean BOP = 13.4%). Both groups showed significant increase in mean BOP% with increasing probing force (0.9%-36.1% in group 1 and 13.4%-47.0% in group 2). Regression analysis revealed an almost linear correlation and a high correlation coefficient between BOP% and probing force. The comparison of the regression lines of the 2 groups showed almost identical slope inclination. However, slight differences in slope inclination were found for different sites: approximal sites clearly yielded steeper regression lines than buccal/oral sites.(ABSTRACT TRUNCATED AT 250 WORDS)

The trabecular bone score (TBS) is an index of bone microarchitectural texture calculated from anteroposterior dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine (LS) that predicts fracture risk, independent of bone mineral density (BMD). The aim of this study was to compare the effects of yearly intravenous zoledronate (ZOL) versus placebo (PLB) on LS BMD and TBS in postmenopausal women with osteoporosis. Changes in TBS were assessed in the subset of 107 patients recruited at the Department of Osteoporosis of the University Hospital of Berne, Switzerland, who were included in the HORIZON trial. All subjects received adequate calcium and vitamin D3. In these patients randomly assigned to either ZOL (n ¼ 54) or PLB (n ¼ 53) for 3 years, BMD was measured by DXA and TBS assessed by TBS iNsight (v1.9) at baseline and 6, 12, 24, and 36 months after treatment initiation. Baseline characteristics (mean AE SD) were similar between groups in terms of age, 76.8 AE 5.0 years; body mass index (BMI), 24.5 AE 3.6 kg/m 2 ; TBS, 1.178 AE 0.1 but for LS T-score (ZOL-2.9 AE 1.5 versus PLB-2.1 AE 1.5). Changes in LS BMD were significantly greater with ZOL than with PLB at all time points (p < 0.0001 for all), reaching þ9.58% versus þ1.38% at month 36. Change in TBS was significantly greater with ZOL than with PLB as of month 24, reaching þ1.41 versus-0.49% at month 36; p ¼ 0.031, respectively. LS BMD and TBS were weakly correlated (r ¼ 0.20) and there were no correlations between changes in BMD and TBS from baseline at any visit. In postmenopausal women with osteoporosis, once-yearly intravenous ZOL therapy significantly increased LS BMD relative to PLB over 3 years and TBS as of 2 years. ß

Results: Baseline characteristics (overall mean ± SD) were similar between groups in terms of age, 67.9± 7.4 years; body mass index, 23.8 ± 3.8 kg/m 2 ; BMD L1-L4, 0.741 ± 0.100 g/cm 2 and TBS, 1.208 ± 0.100. Over 24 months, teriparatide induced a significantly larger increase in LS BMD and TBS than IBN (+7.6% ± 6.3 vs. +2.9% ± 3.3 and +4.3% ± 6.6 vs.+0.3% ± 4.1, respectively; p < 0.0001 for both). LS BMD and TBS were only weakly correlated at baseline (r 2 = 0.04) with no correlation between the changes in BMD and TBS over 24 months. Conclusions:In postmenopausal women with osteoporosis, a 2-year treatment with teriparatide led to a significantly larger increase in LS BMD and TBS than IBN, suggesting that teriparatide had more pronounced effects on bone microarchitecture than IBN.KEY WORDS: osteoporosis, parathyroid hormone, teriparatide, bone mineral density, trabecular bone score, treatment, open-label study MINI ABSTRACTTreatment effects over two years of teriparatide versus ibandronate in postmenopausal women with osteoporosis were compared using lumbar spine BMD and trabecular bone score (TBS). 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 Teriparatide induced larger increases in BMD and TBS compared to ibandronate suggesting a more pronounced effect on bone microarchitecture of the bone anabolic drug.