Penoni, D.C., Leão, A.T.T., Torres, S.R. et al. (4 more authors) (2018) Effects of Bone Fragility and Antiresorptive Drugs on Periodontal Disease and Tooth Loss: A Longitudinal Study. JDR Clinical & Translational Research, 3 (4). pp. 378-387. ISSN 2380-0844
Abstract
This longitudinal study aimed to elucidate whether systemic bone fragility predicts severe periodontal clinical attachment loss (CAL) and tooth loss over the years and to test the influence of bone medication and periodontal maintenance in these relationships. Elderly women were evaluated for bone mineral density (BMD) and for fracture risk assessment (FRAX) in a cross-sectional analysis and retrospective follow-up (6- and 10-y periods). Data on BMD and FRAX were used as indicators of bone fragility in structural equation modeling. Periodontal examination and data on postmenopausal tooth loss were recorded. Multivariate Poisson regression models with robust covariance were used to estimate relative risk (RR) and 95% CI of BMD and FRAX for sites with CAL ≥6 mm and for tooth loss. The cross-sectional analysis included 134 women aged 65 to 80 y, and from them 71 and 49 women had available data for analysis in the 6- and 10-y follow-up periods, respectively. Bone fragility predicted severe CAL over 10 y (e.g., femoral neck: 10-y analysis, β = −0.389, P = 0.005; cross-sectional, β = −0.190, P = 0.004); however, this association did not remain significant when the use of bone medication was evaluated. Poisson regression showed that a better skeletal condition was associated with a lower risk of severe periodontal disease and tooth loss (cross-sectional femoral neck: RR = 0.08, P < 0.001; RR = 0.03, P < 0.001, respectively) when not adjusted for bone medication and periodontal maintenance. The receiver operating characteristic curve suggested that women with osteoporosis should be referred for periodontal assessment (sensitivity = 71.0%, specificity = 70.0%). Bone fragility is a relevant longitudinal predictor of severe periodontal disease and tooth loss among elderly women. The use of bisphosphonates improved the bone condition as well as the periodontal status. Periodontal maintenance also minimized the negative impact of low BMD on teeth-supportive tissues in the studied population.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © International & American Associations for Dental Research 2018. This is an author produced version of a paper subsequently published in JDR Clinical and Translational Research. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 11 Feb 2019 14:12 |
Last Modified: | 11 Feb 2019 14:12 |
Published Version: | https://doi.org/10.1177/2380084418787451 |
Status: | Published |
Publisher: | SAGE Publications |
Refereed: | Yes |
Identification Number: | 10.1177/2380084418787451 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:142359 |