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Association between osteoporosis treatment and severe periodontitis in postmenopausal women

Passos-Soares, Johelle de S. PhD1,2; Vianna, Maria Isabel P. PhD1; Gomes-Filho, Isaac S. PhD2; Cruz, Simone S. PhD2,3; Barreto, Maurício L. PhD4; Adan, Luis F. PhD5; Rösing, Cassiano K. PhD6; Trindade, Soraya C. PhD2; Cerqueira, Eneida M.M. PhD7; Scannapieco, Frank A. PhD8

doi: 10.1097/GME.0000000000000830
Original Articles

Objective: To estimate the association between osteoporosis treatment and severe periodontitis in postmenopausal women.

Methods: This cross-sectional study comprised of 492 postmenopausal women, 113 women in osteoporosis treatment, and 379 not treated. Osteoporosis treatment consisted of systemic estrogen alone, or estrogen plus progestin, and calcium and vitamin D supplements, for at least 6 months. Severe periodontitis was defined as at least two interproximal tooth sites with clinical attachment loss of at least 6 mm, and at least one interproximal site with probing depth of at least 5 mm; and dental caries experience was measured using the decayed, missing, and filled teeth (DMFT) index. Analysis included descriptive statistics and Poisson multivariate analysis with robust variance.

Results: Women receiving osteoporosis treatment had less periodontal probing depth, less clinical attachment loss, and less gingival bleeding than women not receiving treatment for osteoporosis (P ≤ 0.05). In the osteoporosis treatment group, the estimated mean DMFT index score was approximately 20, the most frequent component being the number of missing teeth, and in the nontreated group, the DMFT index was approximately 19. The prevalence of severe periodontitis was 44% lower in the osteoporosis treatment group than in the nontreatment group. The prevalence ratioadjusted was 0.56, 95% confidence interval was 0.31 to 0.99 (P = 0.05), after adjustments for smoking, age, family income, and visit to the dentist.

Conclusions: The results suggest that women treated with estrogen for postmenopausal osteoporosis have a lower prevalence of severe periodontitis than women not receiving treatment.

1Department of Preventive Dentistry, Federal University of Bahia, Bahia, Brazil

2Department of Health, Feira de Santana State University, Bahia, Brazil

3Federal University of Recôncavo Bahiano, Santo Antonio de Jesus, Bahia, Brazil

4Public Health Institute

5Department of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil

6Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

7Department of Biological Sciences, Feira de Santana State University, Bahia, Brazil

8Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY.

Address correspondence to: Johelle de S. Passos-Soares, PhD, Dentistry School, Federal University of Bahia. Av Araujo Pinho, 62, Canela, Salvador, Bahia 40110-150, Brazil. E-mail:

Received 12 October, 2016

Revised 6 December, 2016

Accepted 6 December, 2016

Funding/support: This work was supported by grants from the Research Support Foundation of the State of Bahia, Salvador, Bahia, Brazil; National Council for Scientific and Technological Development, Brasilia, Brazil; and by the State University of Feira de Santana, Bahia, Brazil.

Financial disclosure/conflicts of interest: None reported.

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© 2017 by The North American Menopause Society.