Bone Abstracts

Introduction: Menopause plays an important role in the onset and/or worsening of periodontal disease by the action of sex hormones on the various body systems. Several studies have reported an association between osteoporosis and periodontal destruction. The aim of this study was to evaluate the effect of postmenopausal osteoporosis on periodontal status.

Material and methods: This is a case-control type study, conducted among 30 women attending the Rheumatology Service of the University Hospital Ibn Roch of Casablanca for postmenopausal osteoporosis and 30 postmenopausal women without osteoporosis recruited in the various services of Surgical Dentistry, Prosthetic Joint Consultations and Dental Treatment Facility (CDPF) in Casablanca. The inclusion criteria were; postmenopausal osteoporosis in cases and menopause in control group along with a reason other than periodontal disease. Women should have at least seven teeth. The exclusion criteria were the general diseases affecting oral health, patients on general medications, those who smoked and those who have had a hysterectomy. Periodontal variables were assessed clinically (level of plaque, degree of gingival inflammation, probing depth, attachment loss, mobility, recession and lysis inter-radicular). The DMF index is a composite indicator of carious damage that counts the number of teeth decayed, missing or blocked. Statistical analysis of the data was made by the EPI-INFO 6.0 software Fr. The test used for the comparison of numbers was the χ²-test. The test used for the comparison of means was Student’s test.

Results: The majority of patients were aged between 51 and 60 years (53.4% for cases and 60.1% for the control group) with an average of 57.93±7.14 in osteoporotic patients, and 54.26±6.85 in controls. The mean follow-up of osteoporosis was 3 years old. In this group, all patients were on oral bisphosphonates. No patient received prior hormone replacement therapy for menopause. In both groups, all women had a low socioeconomic level. The average Body Mass Index was 27.25±3.10 to 27.52± cases and 2.44 in controls (P=0.01). There was no significant difference in the DMF index between osteoporotic patients and control patients (13.10±6.69 and 13.40±6.02) (P>0.05). In contrast, patients with osteoporosis had worse dental hygiene: significant plaque accumulation in 53.1% vs 16.5% (P=0.001) and gingival inflammation more pronounced (26.5%) compared with controls (9.9%) (P=0.007). Loss of significant attachment, located mainly at the incisors and lower molars was found in women with osteoporosis (40%) compared to controls (16.6%), P=0.04. No cases of osteonecrosis of the jaw was found.

Discussion: Several studies and clinical research have shown that postmenopausal osteoporosis is a major risk factor for periodontal disease. In osteoporotic patients, the prevalence and risk of developing periodontitis are higher. Probing depth, attachment loss and its severity increase significantly depending on the age and poor hygiene. After this study, we found that the oral hygiene, condition of the teeth and periodontal environment, present the main factors responsible for periodontitis in osteoporotic postmenopausal women.

Conclusion: In light of these results, we stress the need for health education and the establishment of a preventative oral health in osteoporotic postmenopausal women.