Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis.

OBJECTIVES: Although several studies have addressed the relationship between systemic bone mineral status and the severity of periodontitis, there is little knowledge of the relationship between periodontal disease and locally detected bone mineral density. The aim of this study was to compare the mandibular bone mineral density of patients with chronic periodontitis with that of periodontally healthy subjects. METHODS: 48 systemically healthy subjects were included in the study and underwent a periodontal examination to determine their status. 24 subjects were periodontally healthy and the other 24 had moderate or severe chronic periodontitis. The mandibular bone mineral density of the subjects was determined by dual energy X-ray absorptiometry. The region of interest on the body of the mandible was independently determined on the dual energy absorptiometry radiographs, and a computer calculated the bone mineral density of these regions. RESULTS: The mandibular bone mineral density of the subjects with periodontitis was significantly lower than that of the periodontally healthy subjects (p < 0.01). There were significant negative correlations between the mandibular bone mineral density values and parameters related to the amount of periodontal destruction. CONCLUSIONS: Low bone mineral density in the jaw may be associated with chronic periodontitis.

Evaluation of mandibular bone mineral density using the dual-energy X-ray absorptiometry technique in edentulous subjects living in an endemic fluorosis region.

OBJECTIVES: Fluoride is one of the biological trace elements with a strong affinity for osseous, cartilaginous and dental tissue. The dental and skeletal effects of high fluoride intake have already been studied in the literature, but little is known about the effects of high fluoride intake on edentulous mandibles. The purpose of this study was to evaluate the effects of high fluoride intake on mandibular bone mineral density (BMD) measured by the dual-energy X-ray absorptiometry (DXA) technique in edentulous individuals with systemic fluorosis. METHODS: 32 people who were living in an endemic fluorosis area since birth and 31 people who were living in a non-endemic fluorosis area since birth (control group) participated in this study. Systemic fluorosis was diagnosed in the patients using the sialic acid (NANA)/glycosaminoglycan (GAG) ratio. The BMDs of the mandibles were determined by the DXA technique. RESULTS: The serum NANA/GAG ratios in the fluorosis group were significantly lower than those in the control group (p < 0.001). There was also a statistically significant difference in mandibular BMD measurements (p < 0.05) between the systemic fluorosis and control groups, as measured by the DXA technique. Mandibular body BMD measurements were higher in the fluorosis group (1.25 ± 0.24 g cm(-2)) than in the control group (1.01 ± 0.31 g cm(-2)). CONCLUSIONS: The results of the study showed that fluoride intake higher than the optimum level causes increased mandibular BMD in edentulous individuals. Further dose-related studies are needed to determine the effects of high fluoride intake on bony structures of the stomatognathic system.

Oral health in patients on inhaled corticosteroid treatment.

OBJECTIVE: The aim of this study was to investigate the effects of long-term inhaled corticosteroids on bone mineral density (BMD) of the mandible in relation with the tooth loss. DESIGN: Cross sectional analytic study. SUBJECTS AND METHODS: Patients (n = 30) with chronic obstructive pulmonary disease under inhaled corticosteroid therapy for at least 1 year were compared with sex- and age-matched healthy controls (n = 30). BMD of the mandible was measured by dual-energy X-ray absorptiometry. The clinical examination included recording the number of teeth present together with periodontal condition. Levels of serum osteocalcin, alkaline phosphatase, calcium, phosphorus and cortisol were also assessed. RESULTS: BMD of the mandible in patients on corticosteroid treatment was significantly lower than that in the control group (P = 0.001). Patients under treatment had more missing teeth than the control group but the difference did not reach statistical significance. The two groups exhibited similar clinical parameters of periodontal condition. Significantly lower levels of osteocalcin (P < 0.0001), calcium (P = 0.004) and cortisol (P = 0.03) were observed in the patients on corticosteroid treatment. CONCLUSION: Long-term use of inhaled corticosteroids may impair bone metabolism and lead to a marked decrease in the mandibular BMD.