Longitudinal Study of Bone Density and Periodontal Disease in Men

Abstract

Bone loss is a feature of both periodontitis and osteoporosis, and periodontal destruction may be influenced by systemic bone loss. This study evaluated the association between periodontal disease and bone mineral density (BMD) in a cohort of 1347 (137 edentulous) older men followed for an average of 2.7 years. Participants were recruited from the Osteoporotic Fractures in Men Study. Random half-mouth dental measures included clinical attachment loss (CAL), pocket depth (PD), calculus, plaque, and bleeding. BMD was measured at the hip, spine, and whole-body, by dual-energy x-ray absorptiometry, and at the heel by ultrasound. After adjustment for age, smoking, race, education, body mass index, and calculus, there was no association between number of teeth, periodontitis, periodontal disease progression, and either BMD or annualized rate of BMD change. We found little evidence of an association between periodontitis and skeletal BMD among older men.

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

“…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. 18 With the exception of Phipps et al 17 , the results of other longitudinal studies regarding the relationship between systemic BMD and periodontal disease progression support this finding. 19,20 These studies suggest that systemic bone loss arising from uncoupled bone remodelling due to oestrogen deficiency also affects the jawbone and is important for the progression of bone loss in periodontitis.…”

“…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.…”

“…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

“…In the present study, we identified that specifically older men with periodontitis were at risk for fractures. This differs from the perception of a lack of association between periodontitis and osteoporosis in men [26].…”

“…The risk for osteoporosis is generally believed to be higher in women. Studies have failed to confirm an association between osteoporosis and periodontitis in older men [26]. This may, in part, be the result of a high degree of undiagnosed osteoporosis in older men.…”