The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women

Grgić, Olja; Kovacev-Zavisic, Branka; Veljovic, Tanja; Novakovic-Paro, Jovanka; Maravić, Tatjana; Bajkin, Branislav

doi:10.1007/s00784-016-1767-6

Cited by 14 publications

(23 citation statements)

References 39 publications

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“…Some authors have shown that CAL was consistently related to BMD but presented no statistical significance (Reinhardt et al 1999; Tezal et al 2000; Pilgram et al 2002). Otherwise, other authors have found no association between CAL and BMD, osteopenia, and/or osteoporosis (Hildebolt et al 1997; Weyant et al 1999; Famili et al 2005; LaMonte et al 2013; Moeintaghavi et al 2013; Grgić et al 2017).…”

Section: Resultsmentioning

confidence: 91%

Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis

et al. 2017

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Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and has been considered a risk factor for periodontal disease. The aim of this systematic review and meta-analysis was to verify the scientific evidence for the association of periodontal attachment loss with low BMD in postmenopausal women. A systematic search of the literature was performed in databases until August 2016, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria included studies that compared clinical attachment loss (CAL) between postmenopausal women with low and normal BMD. Studies using similar methodology, with lower and higher risk of bias, were pooled into 3 different meta-analyses to compare CAL among women with normal BMD, osteoporosis, and osteopenia. In the first meta-analysis, mean CAL was compared among groups. In the other 2 meta-analyses, the mean percentages of sites with CAL ≥4 mm and ≥6 mm were respectively compared among groups. From 792 unique citations, 26 articles were selected for the qualitative synthesis. Eleven of the studies were appraised as presenting low risk of bias, and the association between low BMD and CAL was observed in 10 of these studies. Thirteen cross-sectional articles were included in the meta-analysis for osteoporosis and 9 in the osteopenia analysis. Women with low BMD presented greater mean CAL than those with normal BMD (osteoporosis = 0.34 mm [95% confidence interval (CI), 0.20-0.49], P < 0.001; osteopenia = 0.07 mm [95% CI, 0.01-0.13], P = 0.02). Only studies with lower risk of bias were available for the analysis of CAL severity. Women with low BMD presented more severe attachment loss, represented as mean percentage of sites with CAL ≥4 mm (osteoporosis = 3.04 [95% CI, 1.23-4.85], P = 0.001; osteopenia = 1.74 [95% CI, 0.36-3.12], P = 0.01) and CAL ≥6 mm (osteoporosis = 5.07 [95% CI, 2.74-7.40], P < 0.001). This systematic review and meta-analysis indicates that postmenopausal women with osteoporosis or osteopenia may exhibit greater CAL compared with women with normal BMD.

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Section: Resultsmentioning

confidence: 91%

Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis

et al. 2017

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“…First, hormone therapy and osteoporosis medication data were not collected. Some studies have pointed out that estrogen use can prevent from tooth loss in PMW [5,14], while the widely used bisphosphonate drugs for the treatment of osteoporosis have been reported to have potential risks of osteonecrosis of the jaw [30]. According to other surveys, only about one-third of Taiwanese PMW have used or are currently treated with hormones or prescription drugs for osteoporosis [13,31].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study

Pan

Hsieh

Chen

et al. 2019

IJERPH

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Many studies have indicated that menopause affects periodontal health and tooth loss. The possible mechanism might due to several hormonal changes and low bone mineral density (BMD) during the transition period. However, few studies have explored the role of oral hygiene in the number of remaining teeth (NRT) in postmenopausal women (PMW). The aim of this study was to explore the prevalence of and factors associated with NRT less than 20 in PMW. A community-based, cross-sectional study was conducted in coastal Yunlin County, Taiwan. NRT was calculated based on natural and filled teeth. BMD was detected by dual-energy X-ray absorptiometry at the collaborating hospital. Logistic regression analyses were used to identify the factors associated with NRT in rural PMW. Six hundred and ten rural PMW with mean age 65.4 years enrolled in this study. The mean NRT was 17.6 (standard deviation [SD] = 10.4), with 43.9% having <20 and 13.9% edentulous. More than half (65.9%) reported that they seldom brushed their teeth after meals, 79.2% rarely used dental floss, and 80% did not regularly undergo tooth scaling by a dentist. The majority of women had low BMD, including 48.7% with osteopenia and 20.7% with osteoporosis. After adjusting for potentially confounding variables, NRT <20 was associated with infrequent tooth scaling (odds ratio [OR] = 2.78, 95% confidence interval [CI] = 1.70–4.56) and dental floss use (OR = 2.01, 95% CI = 1.24–3.26), but not BMD. A high prevalence of NRT <20 was found among rural PMW, but poor oral hygiene rather than low BMD was the major contributing factor. It is an emerging issue for primary healthcare providers and clinicians to initiate oral hygiene promotion programs for these disadvantaged women.

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“…Bone density changes throughout life, but after the menopause a decrease in estrogen production occurs, which seems to be associated with an increased risk of osteoporosis. Decreased bone density in the jaw bone in subjects with osteoporosis is obviously compatible with this condition, leading to attachment loss in individuals with PDIS [ 72 , 73 , 81 , 82 ]. Besides being associated with decreased bone density, estrogen deficiency also affects the other periodontal tissues and the immune response against the periodontal biofilm in a proinflammatory direction [ 81 ].…”

Section: Explanatory Modelsmentioning

confidence: 99%

Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician

Holmstrup

Damgaard

Olsen

et al. 2017

Journal of Oral Microbiology

157

140

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Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson’s disease, Alzheimer’s disease, psoriasis, and respiratory infections. Shared inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status. The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities.

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The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women

Abstract: BP therapy could have a negative influence on the determinants of oral health in postmenopausal women with osteoporosis.

Cited by 14 publications

References 39 publications

Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis

Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis

Factors Associated with Tooth Loss in Postmenopausal Women: A Community-Based Cross-Sectional Study

Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician

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