Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Periodontol. 2020 Oct;91(10):1264-1273. doi: 10.1002/JPER.19-0580. Epub 2020 Apr 22.
The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. Therefore, this cross-sectional study investigated the association between TBS and severe periodontitis.
Eight hundred and five Thai participants, aged 30 to 82 years, underwent bone quality assessment. Their mean TBS was calculated from dual-energy X-ray absorptiometry images at the L1 to L4 lumbar spine using TBS software. Each participant was classified as normal, partially degraded, or degraded TBS. Full-mouth periodontal examinations determined plaque score, probing depth, clinical attachment level (CAL), and the number of remaining teeth. The participants were classified as non-severe or severe periodontitis. Differences in periodontal parameters between the TBS groups were analyzed using one-way ANOVA. The association between TBS and severe periodontitis was assessed with multivariate binary logistic regression. For severe periodontitis, the additive interaction between TBS and oral hygiene status was also analyzed.
The mean CAL was 0.9-mm higher in the degraded TBS group compared with the normal TBS group. Degraded TBS was associated with severe periodontitis with an adjusted odds ratio (OR) of 2.10 (95% confidence interval [CI] = 1.03 to 4.26). The combination of degraded TBS and plaque score ≥80% increased the adjusted OR to 5.71 (95% CI = 1.15 to 28.43).
Degraded TBS is associated with severe periodontitis and has a synergistic effect with poor oral hygiene, suggesting monitoring decreased bone quality and good oral hygiene for promoting the periodontal-systemic health of these individuals.
系统性骨质流失与牙周炎之间的关联仍未得到解决；而骨小梁评分（TBS）是评估骨质量下降的新指标。因此，本横断面研究调查了 TBS 与重度牙周炎之间的关联。
805 名年龄在 30 至 82 岁的泰国参与者接受了骨质量评估。他们的腰椎 L1 至 L4 处的双能 X 射线吸收仪图像的平均 TBS 使用 TBS 软件进行计算。每位参与者被分为正常、部分降解或降解 TBS。全口牙周检查确定菌斑指数、探诊深度、临床附着水平（CAL）和剩余牙齿数。参与者被分为非重度或重度牙周炎。使用单因素方差分析比较 TBS 组之间的牙周参数差异。使用多变量二项逻辑回归评估 TBS 与重度牙周炎之间的关联。对于重度牙周炎，还分析了 TBS 和口腔卫生状况之间的附加交互作用。
与正常 TBS 组相比，降解 TBS 组的平均 CAL 高 0.9mm。降解 TBS 与重度牙周炎相关，调整后的优势比（OR）为 2.10（95%置信区间 [CI] 1.03 至 4.26）。降解 TBS 与菌斑指数≥80%的组合使调整后的 OR 增加到 5.71（95% CI 1.15 至 28.43）。
降解 TBS 与重度牙周炎相关，与口腔卫生不良具有协同作用，这表明监测骨质量下降和保持良好的口腔卫生对于促进这些个体的牙周系统健康很重要。
