Gormez Ozlem, Celebi Elif, Isik Ayse Rabia, Yetkin Ay Zuhal, Orhan Hikmet
Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Suleyman Demirel University, Isparta, Turkey.
School of Dental Medicine, Department of Oral and Maxillofacial Radiology, Bahcesehir University, Istanbul, Turkey.
BMC Oral Health. 2025 Jul 2;25(1):994. doi: 10.1186/s12903-025-06395-3.
Oral health in older adults is frequently compromised due to a higher prevalence of periodontal disease, tooth loss, and systemic conditions such as osteoporosis. Altough the association between periodontitis and osteoporosis has been explored, further research is warranted to assess the periodontal inflammatory burden in the context of bone health. This study hypothesised that periodontal inflammatory burden, measured by Periodontal Inflamed Surface Area (PISA), may contribute to osteoporotic changes in the mandible. The objective was to evaluate the relationship between periodontal status and mandibular osteoporotic changes by assessing inflammatory burden via PISA and panoramic radiomorphometric indices in geriatric individuals.
This retrospective study included 149 patients aged ≥ 65 years. Participants were grouped by periodontal health, and PISA values were calculated. Panoramic radiographs were analysed to assess mandibular bone quality using the Mental Index (MI), Panoramic Mandibular Index (PMI), and Mandibular Cortical Index (MCI). Statistical analyses evaluated the associations between periodontal status, PISA values, and radiomorphometric indices.
The mean participant age was 70 ± 4 years. There were no significant differences in MI, PMI, or MCI among periodontal health groups (p > 0.05). However, PISA values showed substantial correlations with MI (p = 0.024), PMI (p = 0.005), and MCI (p = 0.04), indicating a potential association between periodontal inflammation and mandibular bone structure.
To the best of our knowledge, this is the first study to correlate PISA values with mandibular osteoporotic changes. While the periodontitis stage was not significantly associated with radiomorphometric indices, PISA was. These findings suggest that inflammatory burden, rather than disease severity alone, may influence mandibular bone characteristics. PISA may serve as a valuable indicator of inflammation-related bone changes.
由于牙周疾病、牙齿缺失以及骨质疏松等全身性疾病的患病率较高，老年人的口腔健康常常受到损害。尽管牙周炎与骨质疏松之间的关联已得到研究，但仍需进一步研究以评估在骨骼健康背景下的牙周炎症负担。本研究假设，通过牙周炎症表面积（PISA）测量的牙周炎症负担可能导致下颌骨骨质疏松性改变。目的是通过评估老年个体的PISA炎症负担和全景放射形态计量指标，来评价牙周状况与下颌骨骨质疏松性改变之间的关系。
这项回顾性研究纳入了149名年龄≥65岁的患者。参与者按牙周健康状况分组，并计算PISA值。分析全景X线片，使用颏部指数（MI）、全景下颌指数（PMI）和下颌骨皮质指数（MCI）评估下颌骨质量。统计分析评估了牙周状况、PISA值和放射形态计量指标之间的关联。
参与者的平均年龄为70±4岁。牙周健康组之间的MI、PMI或MCI无显著差异（p>0.05）。然而，PISA值与MI（p=0.024）、PMI（p=0.005）和MCI（p=0.04）显示出显著相关性，表明牙周炎症与下颌骨结构之间可能存在关联。
据我们所知，这是第一项将PISA值与下颌骨骨质疏松性改变相关联的研究。虽然牙周炎阶段与放射形态计量指标无显著关联，但PISA与之相关。这些发现表明，炎症负担而非仅疾病严重程度可能影响下颌骨特征。PISA可能是炎症相关骨改变的一个有价值指标。
