Association between periodontal disease and osteoporosis in postmenopausal women: A systematic review and meta-analysis

Jing Qi; Jiahui Chen; Yunqing Pang; Yufeng Guo; Guang Chen; Yuting Liu; Jing Wang; E Liu

doi:10.1016/j.heliyon.2023.e20922

Association between periodontal disease and osteoporosis in postmenopausal women: A systematic review and meta-analysis

Heliyon. 2023 Oct 20;9(11):e20922. doi: 10.1016/j.heliyon.2023.e20922. eCollection 2023 Nov.

Authors

Jing Qi^{1

2}, Jiahui Chen³, Yunqing Pang^{1

4}, Yufeng Guo², Guang Chen⁵, Yuting Liu⁶, Jing Wang^{1

4}, E Liu²

Affiliations

¹ The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China.
² Stomatology Center of Gansu Provincial Hospital, Lanzhou, 730000, China.
³ Department of Clinical Skills Training Center, The First School of Clinical Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
⁴ School of Stomatology Lanzhou University, Lanzhou, 730000, China.
⁵ Department of Stomatology, Affiliated Hospital of Northwest University for Nationalities, Lanzhou, 730000, China.
⁶ Radiology of Gansu Provincial Hospital, Lanzhou, 730000, China.

Abstract

Objective: To evaluate the relationship between periodontitis and postmenopausal osteoporosis.

Methods: This research was carried out according to the principles laid down by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. We searched the Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang databases from inception to July 1, 2023 to collect all relevant publications, with no restrictions on publication date or Languages. Cochrane's tool for assessing RoB was used to evaluate the RoB for RCTs. The Newcastle-Ottawa Scale was used to assess the RoB for cohort studies and case-control studies. Mean differences (MD) with 95 % confidence intervals (CI) were used for analysis of continuous data. Heterogeneity was measured using the I² statistic. Revman 5.4 software was used for the meta-analysis.

Results: 28 observational studies with 19611 patients, including 5813 cases in the postmenopausal osteoporosis group and 13798 cases in the non-osteoporosis group. The studies showed that the degrees of clinical attachment loss (CAL), probing depth (PD), gingival recession (GR), simplified oral hygiene index (OHIS), and percentage of sites with bleeding on probing (BOP) in the postmenopausal osteoporosis group were higher than those in the non-osteoporosis group[CAL(MD = 0.89(mm), 95 % CI [0.48,1.30], p < 0.00001), PD (MD = 0.27(mm), 95 % CI [0.13, 0.41], p = 0.0001), GR (MD = 0.28(mm), 95 % CI [0.20, 0.35], p < 0.00001), OHIS (MD = 1.32,95 % CI [1.12,1.51], p < 0.00001), BOP(MD = 12.71(%), 95 % CI [3.24,22.18], p = 0.009)]. Eleven studies found that bone mineral density (BMD) in the postmenopausal osteoporosis group was lower than that in non-osteoporosis group (MD = -0.41(U/cm²), 95 % CI [-0.77,-0.05], p = 0.03). The combined analysis results of the studies in the two groups showed that there were no significant differences in the loss of alveolar crestal height (ACH)[(MD = -1.76(%),95%CI [-3.64,0.12], p = 0.07)].

Conclusion: Postmenopausal osteoporosis patients are more likely to suffer from periodontitis, and the condition is easily aggravated.

Keywords: Meta-analysis; Perimenopausal bone loss; Periodontal diseases.

Publication types

Review