Evaluation of the association between osteoporosis and periodontitis in postmenopausal women: A clinical and radiographic study

Saba Zamani; Farin Kiany; Leila Khojastepour; Ali Zamani; Zahra Emami

Evaluation of the association between osteoporosis and periodontitis in postmenopausal women: A clinical and radiographic study

Dent Res J (Isfahan). 2022 Jun 1:19:41. eCollection 2022.

Authors

Saba Zamani¹, Farin Kiany², Leila Khojastepour³, Ali Zamani⁴, Zahra Emami²

Affiliations

¹ Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
² Department of Periodontics, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Department of Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

PMID: 35915711
PMCID: PMC9338350

Abstract

Background: This study aimed to assess the relationship between the osteoporotic condition and periodontitis in postmenopausal women.

Materials and methods: Ninety-four women aged 50-80 years were studied in this cross-sectional study. Bone mineral density (BMD) of lumbar vertebra BMD (LBMD), total hip BMD (HBMD), and neck of femur BMD (NBMD) was assessed using standardized dual-energy X-ray absorptiometry (DXA) (normal: T-score ≥-1, osteopenic: -2.5 ≤ t-score <-1, osteoporotic: T-score <-2.5). Bleeding point index (BI), O'Leary plaque index (PI), and clinical attachment loss (CAL) were recorded. Cementoenamel junction, alveolar-crest distance (CEJ-AC) was measured from cone-beam computed tomography images. Periodontitis severity was represented by CAL and CEJ-AC distance. One-way analysis of variance followed by Post hoc Tukey was performed for examining differences among the groups for different variables. Pearson correlation coefficient® and backward regression analysis were used to investigate the effect of confounding variables on CEJ-AC as the dependent variable. Significance was considered at P < 0.05.

Results: Mean CEJ-AC was significantly higher in the osteoporotic and osteopenic groups compared to the normal group (P = 0.001). There was a significant positive correlation between CEJ-AC and NBMD and LBMD (P < 0.001). The associations between LBMD and CEJ-AC existed even after adjusting for confounding factors (P = 0.002). The differences in BI, PI, and CAL were not statistically different between the groups (P > 0.05).

Conclusion: Although osteoporosis is not the main cause of periodontitis, it can indirectly affect periodontal status by increasing CEJ-AC. Early diagnosis of osteoporosis followed by early referral to a dentist for the treatment of potential existing periodontal diseases is important to avoid complications among postmenopausal women.

Keywords: Alveolar bone loss; cone-beam computed tomography; osteoporosis; periodontitis; postmenopause.