Shapiro Laurence F, Freeman Katherine
N Y State Dent J. 2014 Apr;80(3):30-4.
The literature supports the fact that estrogen plays an important role in skeletal maintenance and remodeling. Estrogen, acting through estrogen receptors in the cells of the periodontal ligament, has a regulatory interaction on bone dynamics through a complex set of basic multicellular units (BMUs). Deficiency of estrogen results in an increased number of BMUs and enhanced bone turnover. The impact of the changes in estrogen deficiency on bone dynamics is primarily mediated through osteoclasts, with greater interdiction of estrogen's actions on trabecular bone than on cortical bone. The purpose of this manuscript is to review the literature for evidence to support an association between estrogen and periodontal disease in adult women, as well as bone mineral density, and to help clarify the mechanism of action. We found in our review of all pertinent databases, including Cochrane, that there are few peer-reviewed clinical studies that examine the relationship between estrogen deficiency and periodontal disease, and bone mineral density (BMD) and periodontal disease. Thus, future research is needed to investigate these associations so that at-risk patients can be identified earlier to avoid functional and esthetic sequellae of periodontal disease.
文献支持雌激素在骨骼维持和重塑中起重要作用这一事实。雌激素通过牙周膜细胞中的雌激素受体发挥作用，通过一组复杂的基本多细胞单位（BMUs）对骨动力学产生调节相互作用。雌激素缺乏会导致BMUs数量增加和骨转换增强。雌激素缺乏变化对骨动力学的影响主要通过破骨细胞介导，雌激素对小梁骨的作用比对皮质骨的作用受到更大的阻断。本手稿的目的是回顾文献，寻找支持成年女性雌激素与牙周病以及骨密度之间关联的证据，并帮助阐明作用机制。我们在对包括Cochrane在内的所有相关数据库的回顾中发现，很少有经过同行评审的临床研究来探讨雌激素缺乏与牙周病以及骨密度（BMD）与牙周病之间的关系。因此，需要未来的研究来调查这些关联，以便能更早地识别高危患者，避免牙周病的功能和美学后遗症。
