Systemic Bone Density and Clinical Oral Health Status in Menopause Women
ABSTRACT Reduced bone mineral density (BMD) is the diagnostic feature of osteoporosis and osteopenia leading to skeletal fragility and fracture. Periodontal diseases are characterized by inflammation within the supporting periodontal tissues. The response of periodontal tissues to local bacterial challenge results in bone resorption and loss of periodontal attachment. The periodontal manifestations in menopause include alveolar bone resorption, clinical attachment loss and tooth loss. Reduced BMD due to the estrogen deficiency represents a variety of conditions in relation to the stability of the structure of the jawbones. Alveolar processes provide the bony framework for teeth support. The loss of systemic bone density in osteoporosis can be a negative consequence on tooth stability. In spite of these findings, low bone mineral density may cause alteration in the mineral content of the alveolar bone and thus can predispose to the progression of periodontal disease, tooth loss and impair the oral health status. Objective: To evaluate the clinical oral health status of menopause women patient with reduced bone mineral density. Materials and Methods: Twenty-seven women were undergone the following tests; BMD of heels were measured by using ultrasound bone densitometer. Oral health status and periodontal health were examined. Orthopantomogram (OPG), blood calcium and alkaline phosphatase level were tested. BMD of lumbar spine L1 to L4 were measured by dual-energy X-ray absorptiometry (DXA). Women under age of 35, subjects receiving long term calcium supplements, systemic steroids and hormonal replacement therapy, subjects with history of parathyroid disease, metabolic bone disease and malignancy and subjects who used tobacco in smoked or smokeless form were excluded from the study. Result: The BMD of lumbar spines were significantly lower in the study group than the controls. Osteopenia was observed in 22% whereas osteoporosis was observed in 55% of cases in study group. Presence of pockets was found significantly in reduced BMD group compared to normal BMD. (p value < 0.05) Conclusion: Increased proportion of osteopenia and osteoporosis in pre and post-menopausal women with periodontitis suggests that there will be strong association between reduced BMD and periodontitis.