Weyant R J, Pearlstein M E, Churak A P, Forrest K, Famili P, Cauley J A
University of Pittsburgh, School of Dental Medicine, Department of Dental Public Health, PA 15261, USA. rjw1+@pitt.edu
J Periodontol. 1999 Sep;70(9):982-91. doi: 10.1902/jop.1999.70.9.982.
Recent research suggests that osteopenia may be a predisposing factor for periodontal tissue destruction. If so, then a relationship should exist between measures of systemic bone mineral density and periodontal tissue destruction. The purpose of the present cross-sectional study was to evaluate the association between systemic bone mineral density and the clinical signs of periodontal tissue destruction in a large population of elderly dentate women.
A total of 292 dentate women (average age 75.5 years) were randomly selected for a cross-sectional periodontal substudy from participants at the Pittsburgh Field Center of the Study of Osteoporotic Fractures (SOF), a prospective study of a cohort of elderly women (age > or =65 years at baseline) to determine risk factors for fractures. Bone mineral density (BMD) was measured using single photon absorptiometry (radius, calcaneus) and dual energy x-ray absorptiometry (hip, spine). Oral health examinations, including periodontal probings and an assessment of bleeding on probing, were made using an NIDR probe at 3 buccal sites of all teeth. Multiple regression models were used to assess the association between bone mineral density and measures of periodontal disease status while controlling for potential confounders. Periodontal status variables examined included: average loss of periodontal attachment (LOA); number of sites with at least 4 mm LOA; number of sites with at least 6 mm LOA; number of sites with bleeding on probing; and deepest probing depth per person.
This study found no statistically significant association between the 5 indicators of periodontal disease and measures of systemic BMD at 8 anatomic sites after controlling for age, smoking, and number of remaining natural teeth. Some suggestive findings support a weak association between generalized osteopenia and periodontal disease.
Systemic osteopenia is, at best, only a weak risk factor for periodontal disease in older non-black women.
近期研究表明，骨质减少可能是牙周组织破坏的一个诱发因素。如果是这样，那么全身骨矿物质密度测量值与牙周组织破坏之间应该存在某种关系。本横断面研究的目的是评估在大量老年有牙女性中全身骨矿物质密度与牙周组织破坏临床体征之间的关联。
从骨质疏松性骨折研究（SOF）匹兹堡现场中心的参与者中随机选取292名有牙女性（平均年龄75.5岁）进行横断面牙周亚研究，SOF是一项对老年女性队列（基线年龄≥65岁）进行的前瞻性研究，旨在确定骨折的危险因素。使用单光子吸收法（测量桡骨、跟骨）和双能X线吸收法（测量髋部、脊柱）测量骨矿物质密度（BMD）。使用国立牙科研究所（NIDR）探针在所有牙齿的3个颊侧部位进行口腔健康检查，包括牙周探诊和探诊出血评估。在控制潜在混杂因素的同时，使用多元回归模型评估骨矿物质密度与牙周疾病状态测量值之间的关联。所检查的牙周状态变量包括：牙周附着丧失（LOA）的平均值；至少有4mm LOA的部位数量；至少有6mm LOA的部位数量；探诊出血的部位数量；以及每人最深探诊深度。
在控制年龄、吸烟和剩余天然牙数量后，本研究发现牙周疾病的5项指标与8个解剖部位的全身BMD测量值之间无统计学显著关联。一些提示性结果支持全身性骨质减少与牙周疾病之间存在弱关联。
对于老年非黑人女性，全身性骨质减少充其量只是牙周疾病的一个弱危险因素。
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