The Association Between Postmenopausal Osteoporosis and Periodontal Disease

Filho, Isaac Suzart Gomes; Passos, Johelle de Santana; Cruz, Simone Seixas da; Vianna, Maria Isabel Pereira; Cerqueira, Eneida de Moraes Marcílio; Oliveira, Denise Cerqueira; Santos, Celso A. S.; Coelho, Julita Maria Freitas; Sampaio, Fábio P.; Freitas, Camila Oliveira Teixeira de; Oliveira, Nelson Fernandes de

doi:10.1902/jop.2007.070057

Cited by 63 publications

(79 citation statements)

References 32 publications

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“…In the present study, CAL is not a strong predictor of estimating BMD (β=0.009, p=0.314), this could be due to the fact that as we do not have data on the premenopausal periodontal health of the women in our study, it is possible that the attachment loss occurred prior to menopause and thus cannot directly be correlated to the postmenopausal osteopenia. Some studies e446 failed to find any correlation between CAL and BMD (3,5,14,16,18), while some found positive association between the two (19,20). Different study populations, sample sizes, and lack of consideration of confounding variables and effect modifiers explain some of this inconsistency in the results.…”

Section: Discussionmentioning

confidence: 99%

Association between periodontal disease and bone mineral density in postmenopausal women: A cross sectional study

Sultan¹,

Rao²

2011

Med Oral

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Objectives: Both periodontitis and osteoporosis represent major health problems especially in elderly women. The relationship between the two diseases and oral bone loss is important having significant public health impact in the prevention of morbidity and mortality related to these disorders. The present study was aimed to investigate the possible association between osteoporosis and periodontal disease among postmenopausal women residing in Goa, India. Study design: A complete periodontal examination (all teeth except third molar) including plaque index (PI), gingival index (GI), clinical attachment loss (CAL) measurement was performed on 80 dentate Goan postmenopausal women (age ≥ 50 yrs) with generalized chronic periodontitis. Mean alveolar bone loss (ABL) was measured from full mouth intraoral periapical radiographs, by recording the distance from cementoenamel junction (CEJ) and the most coronal portion of alveolar crest at mesial and distal aspect of all teeth except canines and third molars. Systemic bone loss was determined from hand-wrist radiograph of the patient through Digital X-Ray Radiogrammetry. Statistical analysis was done to assess the relationships between periodontal variables and bone mineral density (BMD) after adjusting for age, years since menopause, body mass index (BMI), smoking, number of remaining teeth, PI and GI. Results: Age of the patient, years since menopause and BMI showed significant correlation with BMD. CAL and ABL showed mildly negative and statistically nonsignificant correlation with the BMD. Of all the variables studied, only smoking and BMI were strong predictors of BMD. Conclusion: Skeletal BMD is related to interproximal ABL and CAL, though not to a statistically significant level; implicating postmenopausal osteopenia as a risk indicator for periodontal disease.

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Section: Discussionmentioning

confidence: 99%

Association between periodontal disease and bone mineral density in postmenopausal women: A cross sectional study

Sultan¹,

Rao²

2011

Med Oral

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“…Nowadays, osteoporosis is considered as one of the risk factors for periodontal disease and tooth loss (Brennan et al 2007;Gomes-Filho et al 2007). Clinical observations in postmenopausal women have confirmed an increased prevalence of periodontal disease with low estrogen levels, even when oral hygiene remains unchanged (Krall et al 1994;Reinhardt et al 1999).…”

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confidence: 99%

Estrogen Deficiency Leads to Impaired Osteogenic Differentiation of Periodontal Ligament Stem Cells in Rats

Zhang

Liu

Zhou

et al. 2011

Tohoku J. Exp. Med.

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Estrogen deficiency in post-menopausal women is considered as one of the risk factors for periodontal diseases. The periodontal ligament is a connective tissue that connects cementum and alveolar bone to constrain teeth within the jaw. Periodontal ligament stem cells (PDLSCs) isolated from the periodontal ligament can differentiate into many types of specialized cells, including osteoblast-like cells that can be used to regenerate alveolar bone. However, little is known about the effect of estrogen-deficient microenvironment on the osteogenic differentiation of PDLSCs. The aim of this study was to explore the role of estrogen on the potential for osteogenic differentiation of PDLSCs using a rat model of osteoporosis. Three-month-old female Sprague-Dawley rats were divided into two groups (n = 6 for each): ovariectomized (OVX) and sham-operated rats (Sham). Then the characteristics of PDLSCs isolated from these rats were investigated. Real-time PCR analysis showed the lower expression levels of estrogen receptors (ERα and ERβ) mRNAs in PDLSCs of OVX animals compared to Sham control. Mineralization assay demonstrated fewer calcium deposits in PDLSCs from OVX group than those from Sham group. Treatment with 17β-estradiol (E2) significantly enhanced the osteogenic differentiation of PDLSCs from both groups in vitro. Furthermore, by means of lentivirus-mediated siRNA targeting ERα or ERβ, the expression of ERα or ERβ was down-regulated (> 50% reduction), which impaired the estrogen-induced osteogenic differentiation of PDLSCs from both groups (> 50% reduction). These results indicate that estrogen plays an important role in maintaining osteogenic differentiation of PDLSCs, which acts through both ERα and ERβ.

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“…[16] Generalized osteopenia and periodontal disease recognized as chronic and closely related to advancing age, are major public health concerns today. [17] Advancing age and the onset of menopause in women is associated with estrogen defi ciency, and it sets in a series of immunoinfl ammatory changes. Estrogen defi ciency predisposes to generalized osteopenia, and postmenopausal women are at a higher risk for developing osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

Effect of subgingivally delivered simvastatin in postmenopausal women with chronic periodontitis: A randomized controlled trial

Gaekwad¹,

Gujjari²,

Kumar³

et al. 2015

JCRI

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Background and Objectives:The defi ciency of estrogen at menopause is a contributing factor that increases susceptibility to resorption due to periodontal infl ammation. Statins have been used successfully in postmenopausal osteopenia. Simvastatin has antiinfl ammatory and antiresorptive properties. This study assessed subgingivally delivered 1.2 mg simvastatin in situ gel in postmenopausal women with chronic periodontitis. Materials and Methods: A total of 40 bilateral pockets (≥4 mm) in 20 systemically healthy postmenopausal subjects were randomized as site A and B, which received either the simvastatin in situ gel or placebo gel after scaling and root planing. Site-specifi c indices, probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 3 and 6 months. The data were analyzed using descriptive statistics, repeated measure ANOVA, paired and independent samples t-test. Results: A statistically signifi cant (P < 0.05) decrease in PD and improved CAL was observed in both groups over 3 and 6 months. The comparisons of clinical parameters showed statistically signifi cant (P < 0.05) improvements in test sites over the control sites. Conclusion: Simvastatin in situ gel showed improvements in clinical parameters and prolonged anti-infl ammatory eff ects. The results encourage the use of simvastatin in situ gel for the predictable treatment of chronic periodontitis in postmenopausal women.

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The Association Between Postmenopausal Osteoporosis and Periodontal Disease

Abstract: Postmenopausal women with osteoporosis and low educational levels have a greater chance of having periodontal disease than do those without osteoporosis.

Cited by 63 publications

References 32 publications

Association between periodontal disease and bone mineral density in postmenopausal women: A cross sectional study

Association between periodontal disease and bone mineral density in postmenopausal women: A cross sectional study

Estrogen Deficiency Leads to Impaired Osteogenic Differentiation of Periodontal Ligament Stem Cells in Rats

Effect of subgingivally delivered simvastatin in postmenopausal women with chronic periodontitis: A randomized controlled trial

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