Persson R E, Hollender L G, Powell L V, MacEntee M I, Wyatt C C L, Kiyak H A, Persson G R
Department of Oral Medicine, University of Washington, Seattle, WA,USA.
J Clin Periodontol. 2002 Sep;29(9):796-802. doi: 10.1034/j.1600-051x.2002.290902.x.
Osteoporosis (OPOR) is a common chronic disease, especially in older women. Patients are often unaware of the condition until they experience bone fractures. Studies have suggested that OPOR and periodontitis are associated diseases and exaggerated by cytokine activity. Panoramic radiography (PMX) allows studies of mandibular cortical index (MCI), which is potentially diagnostic for OPOR.
i). To study the prevalence of self-reported history of OPOR in an older, ethnically diverse population, ii). to assess the agreement between PMX/MCI findings and self-reported OPOR, and iii). to assess the likelihood of having both a self-reported history of OPOR and a diagnosis of periodontitis.
PMX and medical history were obtained from 1084 subjects aged 60-75 (mean age 67.6, SD +/- 4.7). Of the films, 90.3% were useful for analysis. PMXs were studied using MCI. The PMXs were used to grade subjects as not having periodontitis or with one of three grades of periodontitis severity.
A positive MCI was found in 38.9% of the subjects, in contrast to 8.2% self-reported OPOR. The intraclass correlation between MCI and self-reported OPOR was 0.20 (P < 0.01). The likelihood of an association between OPOR and MCI was 2.6 (95%CI: 1.6, 4.1, P < 0.001). Subjects with self-reported OPOR and a positive MCI had worse periodontal conditions (P < 0.01). The Mantel-Haentzel odds ratio for OPOR and periodontitis was 1.8 (95%CI: 1.2, 2.5, P < 0.001).
The prevalence of positive MCI was high and consistent with epidemiological studies, but only partly consistent with a self-reported history of osteoporosis with a higher prevalence of positive MCI in Chinese women. Horizontal alveolar bone loss is associated with both positive self-reported OPOR and MCI.
骨质疏松症（OPOR）是一种常见的慢性疾病，在老年女性中尤为常见。患者往往在发生骨折时才意识到病情。研究表明，OPOR与牙周炎相关，且细胞因子活性会加剧这种关联。全景X线摄影（PMX）可用于研究下颌骨皮质指数（MCI），其对OPOR可能具有诊断价值。
i）研究一个年龄较大、种族多样的人群中自我报告的OPOR病史的患病率；ii）评估PMX/MCI检查结果与自我报告的OPOR之间的一致性；iii）评估同时具有自我报告的OPOR病史和牙周炎诊断的可能性。
从1084名年龄在60 - 75岁（平均年龄67.6岁，标准差±4.7）的受试者中获取PMX和病史。其中，90.3%的X光片可用于分析。使用MCI对PMX进行研究。根据PMX将受试者分为无牙周炎或患有三种不同严重程度牙周炎之一。
38.9%的受试者MCI呈阳性，而自我报告有OPOR的仅占8.2%。MCI与自我报告的OPOR之间的组内相关性为0.20（P < 0.01）。OPOR与MCI之间存在关联的可能性为2.6（95%置信区间：1.6, 4.1，P < 0.001）。自我报告有OPOR且MCI呈阳性的受试者牙周状况更差（P < 0.01）。OPOR与牙周炎的Mantel-Haentzel优势比为1.8（95%置信区间：1.2, 2.5，P < 0.001）。
MCI阳性的患病率较高，与流行病学研究一致，但仅部分与自我报告的骨质疏松病史一致，中国女性中MCI阳性的患病率更高。水平牙槽骨吸收与自我报告的OPOR阳性和MCI阳性均相关。
