Citation Information :
Manjunath SH, Rakhewar P, Nahar P, Tambe V, Gabhane M, Kharde A. Evaluation of the Prevalence and Severity of Periodontal Diseases between Osteoporotic and Nonosteoporotic Subjects: A Cross-sectional Comparative Study. J Contemp Dent Pract 2019; 20 (10):1223-1228.
Aim: To evaluate the prevalence and severity of periodontal diseases between osteoporotic and nonosteoporotic subjects.
Materials and methods: The study population included 140 subjects (70 osteoporotic and 70 nonosteoporotic) age group of 35–70 years. Skeletal (calcaneal) bone mineral density (BMD) was measured by quantitative ultrasound technique (QUS) for T score values. Periodontal status was examined by plaque index (PI), bleeding index, probing depth (PD) and clinical attachment level. Digital panoramic and intraoral periapical radiographs (IOPA) were taken with fixed reference point for evaluation of bone interdental alveolar bone loss (ABL). The recorded data for T score, interdental ABL and periodontal status were subjected to statistical analysis for correlation and regression procedure.
Results: The prevalence of the periodontal diseases, in osteoporotic group 120 (54.5%) were with periodontitis and in nonosteoporotic group 100 (50%) were with periodontitis. Correlation of T score with age, PI, gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), and ABL in nonosteoporotic group was found statistically not significant. The age was (r = −0.052) indicating positive association with weak correlation, The PI is (r 0.060) indicating positive association, the GI was (r = −0.053) indicating negative association with weak correlation, the PPD was (r = 0.070) indicating positive association with weak correlation, the CAL was (r = 0.133) indicating positive association with weak correlation, ABL was (r 0.027) indicating positive association with weak correlation.
Conclusion: Calcaneal BMD was related to ABL and, to a less extent, to CAL, implicating osteoporotic subjects are at high risk indicator for periodontal diseases.
Clinical significance: Even though the pathogenesis of periodontitis and osteoporosis differs; these diseases have several common risk factors. Both may have a additive impact on patients, which requires concomitant medical and dental management which mandates simultaneous diagnosis of both.
Gopinath V, Prabhu MN, Suryawanshi H. Osteoporosis and periodontal disease: a review. Int J Innov Dent Sci 2016;1:27–37.
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001;285(6):785–795. DOI: 10.1001/jama.285.6.785.
Nagi R, Kantraj YB, Nagaraju R, et al. Risk factors, quality of life and oral implication of osteoporosis in postmenopausal women. J Indian Acad Oral Med Radiol 2016;28(3):274–280. DOI: 10.4103/0972-1363.195663.
World Health Organization, Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO study group. World Health Organ Tech Rep Ser 1994, 843, 1–129.
Wasnich R. Bone mass measurement: prediction of risk. Am J Med 1993;95(5A):6S–10S. DOI: 10.1016/0002-9343(93)90374-X.
von Wowern N, Klausen B, Kallerup G. Osteoporosis: a risk factor in periodontal disease. J Periodontol 1994;65(12):1134–1138. DOI: 10.1902/jop.19126.96.36.1994.
Wang CW, McCauley LK. Osteoporosis and periodontitis. Curr Osteoporos Rep 2016;14(6):284–291. DOI: 10.1007/s11914-016-0330-3.
World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group (Technical reports series). Geneva: WHO; 1994. pp. 1–129.
Sultan N, Rao J. Association between periodontal disease and bone mineral density in postmenopausal women: a cross sectional study. Med Oral Patol Oral Cir Bucal 2011;16(3):e440–e447. DOI: 10.4317/medoral.16.e440.
Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22(1):121–135. DOI: 10.3109/00016356408993968.
Löe H, Silness J. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6 Suppl):610–616. DOI: 10.1902/jop.19188.8.131.520.
Tuck SP, Datta HK. Osteoporosis in the aging male: treatment options. Clin Interv Aging 2007;2(4):521–536. DOI: 10.2147/cia.s820.
Pouilles JM, Tremollieres F, Ribot C. Effect of menopause on femoral and vertebral bone loss. J Bone Miner Res 1995;10(10):1531–1536. DOI: 10.1002/jbmr.5650101014.
Phipps KR, Chan BK, Madden TE, et al. Longitudinal study of bone density and periodontal disease in men. J Dent Res 2007;86(11): 1110–1114. DOI: 10.1177/154405910708601117.
Mohammad AR, Hooper DA, Vermilyea SG, et al. An investigation of the relationship between systemic bone density and clinical periodontal status in post-menopausal Asian-American women. Int Dent J 2003;53(3):121–125. DOI: 10.1111/j.1875-595X.2003.tb00735.x.
Yoshihara A, Seida Y, Hanada N, et al. A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults. J Clin Periodontol 2004;31(8):680–684. DOI: 10.1111/j.1600-051X.2004.00548.x.
Renvert S, Berglud J, Persson RE, et al. Osteoporosis and periodontitis in older subjects participating in the Swedish National Survey on aging and Care (SNAC-Blekinge). Acta Odontol Scand 2011;69(4): 201–207. DOI: 10.3109/00016357.2010.549501.
Vishwanth SB, Kumar V, Kumar S, et al. Correlation of periodontal status and bone mineral density in postmenopausal women: a digital radiographic and quantitative ultrasound study. Indian J Dent Res 2011;22(2):270–276. DOI: 10.4103/0970-9290.84303.
Al Habashneh R, Alchalabi H, Khader YS, et al. Association between periodontal disease and osteoporosis in postmenopausal women in Jordan. J Periodontol 2010;81(11):1613–1621. DOI: 10.1902/jop.2010.100190.
Aspalli SS, Shetty VS, Parab PG, et al. Osteoporosis and periodontitis: is there a possible link? Indian J Dent Res 2014;25(3):316–320. DOI: 10.4103/0970-9290.138327.
Ryan CS, Petkov VI, Adler RA. Osteoporosis in men: the value of laboratory testing. Osteoporos Int 2011;22(6):1845–1853. DOI: 10.1007/s00198-010-1421-0.
Wactawski-Wende J. Periodontal diseases and osteoporosis: association and mechanisms. Ann Periodontol 2001;6(1):197–208. DOI: 10.1902/annals.2001.6.1.197.
Elders PJ, Habets LL, Netelenbos JC. The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age. J Clin Periodontol 1992;19(7):492–496. DOI: 10.1111/j.1600-051X.1992.tb01162.x.
Ardashir L, Reza A, Mahdi K, et al. Is there any association between systemic bone mineral density and clinical manifestations of periodontal disease? J Periodontol Implant Dent 2012;4(2):49–55.
Tezal M, Wende JW, Grossi SG, et al. The relationship between bone mineral density and periodontitis in post menopausal women. J Periodontol 2000;71(9):1492–1498. DOI: 10.1902/jop.2000.71.9.1492.