Association of osteoporosis and bone medication with the periodontal condition in elderly women

Osteoporos Int. 2016 May;27(5):1887-96. doi: 10.1007/s00198-015-3437-y. Epub 2015 Dec 1.

Abstract

This study investigated whether osteoporosis and its treatment may affect periodontal condition in elderly women. The findings highlighted that women with osteoporosis had a higher chance to present severe periodontitis than women with normal bone mineral density (BMD), particularly those who were not treated for osteoporosis.

Introduction: This study investigated whether osteoporosis increases the frequency and severity of chronic periodontitis in elderly women and evaluated the influence of vitamin D and osteoporosis treatment in the periodontal condition.

Methods: In this cross-sectional study, elderly women were selected among 1266 subjects evaluated for lumbar spine and proximal femur bone mineral density (BMD) using dual energy X-ray absorptiometry. Sociodemographic, clinical characteristics, and complete periodontal examination were recorded. Serum 25-hydroxyvitamin D levels were measured by chemiluminescence.

Results: Forty-eight elderly women with normal BMD and 86 with osteoporosis were selected. Women with osteoporosis presented higher frequency of sites with clinical attachment level ≥6 mm (p = 0.003) and gingival recession ≥3 mm (p = 0.002) than those with normal BMD and were more than twice as likely to present severe periodontitis (odds ratio (OR) = 2.49, 95 % CI [1.14 to 5.43]). Osteoporotic women who were not treated for the condition had more chance to present severe periodontitis (OR = 3.16, 95 % CI [1.28 to 7.82]) than those who did use bisphosphonates (OR = 2.04, 95 % CI [0.85 to 4.89]). Among the participants who presented low levels of vitamin D, those with osteoporosis exhibited a higher chance to present severe periodontitis than those with normal BMD (p = 0.027), but the association between vitamin D levels and osteoporosis was not statistically significant after adjustment (p = 0.198).

Conclusions: Elderly women with osteoporosis have a greater chance to present periodontitis, with higher severity than those with normal BMD. Osteoporosis treatment provides protection for periodontitis.

Keywords: Bisphosphonates; Bone density; Elderly; Osteoporosis; Periodontitis; Vitamin D.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon / methods
  • Aged
  • Aged, 80 and over
  • Bone Density
  • Bone Density Conservation Agents / therapeutic use*
  • Chronic Disease
  • Cross-Sectional Studies
  • Female
  • Femur / physiopathology
  • Humans
  • Lumbar Vertebrae / physiopathology
  • Osteoporosis, Postmenopausal / complications*
  • Osteoporosis, Postmenopausal / drug therapy*
  • Osteoporosis, Postmenopausal / physiopathology
  • Periodontitis / etiology*
  • Periodontitis / physiopathology
  • Periodontitis / prevention & control
  • Socioeconomic Factors
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood

Substances

  • Bone Density Conservation Agents
  • Vitamin D
  • 25-hydroxyvitamin D