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

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
Key Words: Alveolar bone loss, cone‑beam computed tomography, osteoporosis,
periodontitis, postmenopause