Investigation of the Relationship between Osteoporosis and Tooth Loss in Menopausal Women

Document Type : Original Article


1 Professor of Obstetrics & Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor of Periodontology, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Resident of Orthodontics, Islamic Azad University of Khorasgan, Isfahan, Iran.

4 Associate Professor of Biostatistics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Osteoporosis is the most common bone metabolic disease worldwide. On the other hand, periodontitis is one of the main factors of tooth loss in aged persons; especially in the case group of this study: menopausal women. Since different studies have reported opposite results in this regard, we aimed to evaluate the effect of osteoporosis on tooth loss status.
Methods: This study was performed based on evaluation of bone-density of tight and back with method of Dual energy X-ray absorptiometry in 2010. A total of 60 patients referring to Bone Densitometry Center of Imam Reza hospital who met the required criteria were selected and divided into three groups of Osteoporosis, Osteopenia, and normal. Then evaluation on periodontal markers such as bone decline and tooth loss (TL) was performed. The patients doubtful to periodontal disease and bone decline were referred for panoramic radiography. Finally, evaluated periodontal markers were compared in three groups. Data were analyzed by SPSS software version 11.5 and statistical dependent T test was examined. P equal or less than 0.05 was considered statistically significant.
Results: Mean bone-decline was more in osteoporosis group rather than two other groups, but the difference was not significant (P=0.065). Also, mean of tooth loss (p=0.884) was not significantly different between three groups of Osteoporosis, Osteopenia, and normal group.
Conclusion: In this study, no significant difference was observed between three groups in terms of bone decline and tooth loss. However, more studies covering all possible interventional variables and performing linear studies are necessary.


1. Andreoli TE, Carpenter CCJ, Griggs RC, Loscalzo J. Cecil essentials of medicine. 5th ed. Philadelphia:WB
2. Wactawski-Wende J, Grossi SG, Trevisan M, Genco RJ, Tezal M, Dunford RG, et al. The role of osteopenia in
oral bone loss and periodontal disease. J Periodontol 1996 Oct;67(10 Suppl):1076-84.
3. Genco RJ, Loe H. The role of systemic conditions and disorders in periodontal disease. Periodontol 2000 1993
4. Eddy DM, Johnston CC, Cummings SR, Dawnson-Hughes B, Lindsay R, Melton LJ, Slemenda CW.
Osteoporosis: review of the evidence for prevention, diagnosis, and treatment and cost-effectiveness analysis.
Status Report. Osteoporos Int 1998;4(Suppl):1-80.
5. Augat P, Fuerst T, Genant HK. Quantitative bone mineral assessment at the forearm: a review. Osteoporosis Int
6. Ballard PA, Purdie DW, Langton CM, Steel SA, Mussurakis S. Prevalence of osteoporosis and related risk
factors in UK women in the seventh decade: osteoporosis case finding by clinical referral criteria or predictive
model? Osteoporos Int 1998;8(6):535-9.
7. Carranza FA, Newman MG, Takei HH. Clinical periodontology. 9th ed. Philadelphia:WB Saunders;2002:204-523.
8. Otogoto J, Ota N. [Correlation between periodontal disease and osteoporosis using panoramic radiographic
parameters for diagnosed osteoporosis in dental clinic] [Article in Japanese]. Clin Calcium 2003 May;13(5):582-6.
9. Gomes-Filho IS, Passos Jde S, Cruz SS, Vianna MI, Cerqueira Ede M, Oliveira DC, et al. The association
between postmenopausal osteoporosis and periodontal disease. J Periodontol 2007 Sep;78(9):1731-40.
10. Kribbs PJ, Chesnunt CH, Ott SM, Kilcoyne RF. Relationships between mandibular and skeletal bone in an
osteoporosis population. J Prosthet Dent 1989 Dec;62(6):703-7.
11. Elders PJ, Habets LL, Netelenbos JC, van der Linden LW, van der Stelt PF. The relation between periodontitis
and systemic bone mass in women between 46 and 55 years of age. J Clin Periodontol 1992 Aug;19(7):492-6.
12. Poor G, Atkinson EJ, O’Fallon WM, Melton LJ. Predictors of hip fractures in elderly men. J Bone Miner Res
1995 Dec;10(12):1900-7.
13. Khorsand A, Paknejad M, Vakili F. [Evaluation of periodonal condition of menopause with women osteopenia and
comparision with control group] [Article in Persian]. J Dentis Tehran Uni Med Sci 2006 Autumn;19(3}:76-83.
14. Lundstram A, Jendle J, Stenstram B, Toss G, Ravald N. Periodontal conditions in 70-year-old women with
osteoporosis. Swed Dent J 2001;25(3):89-96.
15. Sarlati F, Talaeipour AR, Rashedi L. [Evaluation of periodontal in posmenopausal women] [Article in Persian].
J Dentis Tehran Uni Med Sci 2005;18(3):59-65.
16. Hock JM, Gera I. Effect of continuous and intermittent administration and inhibition of resorption on the
anabolic response of bone to parathyroid hormone. J Bone Miner Res 1992 Jan;7:65-72.
17. Atrushkevitch VG, Mkrtumyan AM. Dental status of women in the post-menopause period. Gerontologija
18. Sultan N, Rao J. Association between periodontal disease and bone mineral density in postmenopausal women: a
cross-sectional study. Med Oral Pathol Oral Cir Bucal 2011 May;16(3):e440-7.
19. Payne JB, Reinhardt RA, Nummikoski PV, Patil KD. Longitudinal alveolar bone loss in postmenopausal
osteoporotic/osteopenic women. Osteoporos Int 1999;10(1):37-40.
20. Persson RE, Hollender LG, Powell LV, MacEntee MI, Wyatt CC, Kiyak HA, et al. Assessment of periodontal
conditions and systemic disease in older subjects. I. Focus on osteoporosis. J Clin Periodontol 2002
21. Shen EC, Gau CH, Hsieh YD, Chang CY, Fu E. Periodontal status in post-menopausal osteoporosis: a
preliminary clinical study in Taiwanese women. J Chin Med Assoc 2004 Aug;67(8):389-393.
22. Pejcic A, Kojovic D, Grigorov I, Stamenkovic B. Periodontitis and osteoporosis. Facta Universitatis
23. Lopes FF, Loureiro FH, Pereira Ade F, Pereira AL, Alves CM. [Association between osteoporosis and
periodontal disease] [Article in Portuguese]. Rev Bras Ginecol Obstet 2008 Aug;30(8):379-83.
24. Al Habashneh R, Alchalabi H, Khader YS, Hazza’a AM, Odat Z, Johnson GK. Association between periodontal
disease and osteoporosis postmenopausal women in jordan. J Periodontol 2010;Nov;81(11):1613-21.
25. Megson E, Kapellas K, Bartold PM. Relationship between periodontal disease and osteoporosis. Int J Evid
Based Health 2010 Sep;8(3):129-39.
26. Shum I, Leung PC, Kwok A, Corbet EF, Orwoll ES, Phipps KR, Jin L. Periodontal conditions in elderly men
with and without osteoporosis or osteopenia. J Periodontol 2010 Oct;81(10):1396-402.
27. Martinez-Maestre MA, Gonzalez-Cejudo C, Machuca G, Torrejon R, Castelo-Branco C. Periodontitis and
osteoporosis: a systematic review. Climacteric 2010 Dec;13(6):523-9.
28. Khadem N, Rahmani ME , Sanaei A, Afiat M. Association between preterm and low-weight birth with
periodontal disease: a case-control study. Iran J Reprod Med 2012:in Press