Abstract
Aim: To correlate the oral signs, salivary calcium, phosphorus, alkaline phosphatase levels and dental radiographic findings in postmenopausal osteoporotic, osteopenic and non-osteoporotic women. Materials and Methods: Forty-five subjects were selected based on bone mineral density (BMD) analyses and were assigned to 3 groups (n=15): Group 1 - established osteoporotic women; Group II - established osteopenic women; Group III (control) - non-osteoporotic women. Complete oral and radiographic examination, saliva collection and analysis of calcium, phosphorus and alkaline phosphatase were performed. Results: The results were tabulated and analyzed for statistical significance using the Mann-Whitney U-test. There was statistically significant difference (p<0.05) in salivary calcium, phosphorus and alkaline phosphatase levels when osteoporotic and osteopenic women were compared to the controls. Conclusion: Salivary parameters can be used as indicators to aid in the diagnosis of osteoporosis and osteopenia in postmenopausal women.References
Consensus report. Periodontal diseases: Epidemiology and diagnosis. Ann Periodont. 1996; 1: 216-22.
Felson DT, Zhang Y, Hannan MT, Kiel DP, Wilson PW, Anderson JJ. The effect of postmenopausal estrogen therapy on bone density in elderly women. N Engl J Med. 1993; 329: 1141-6.
Kiel DP, Felson DT, Anderson JJ, Wilson PW, Moskowitz MA. Hip fracture and the use of estrogens in postmenopausal women. The Framingham Study. N Engl J Med. 1987; 317: 1169-74.
Lindsay R. Estrogens, bone mass and osteoporotic fracture. Am J Med. 1991; 91: 10S-13S.
Vinco L, Prallet B, Chappard D, Pupier R. Contributions of chronological age, age at menarche and menopause and of anthropometric parameters to axial and peripheral bone densities. Osteoporosis Int. 1992; 2: 153-8.
Taguchi A, Tanimoto K, Suei Y, Wada T, Otani K. Oral signs as indicators of possible osteoporosis in elderly women Oral Surg Oral Med Oral Pathol. 1995; 80: 612-6.
Garnero P, Delmas PD. Biochemical markers of bone turnover. Applications for osteoporosis. Endocrinol Metab Clin North Am. 1998; 27: 303-23.
Midtby M, Magnus JH. Can biochemical markers for bone density be recommended as diagnostic and prognostic tools in osteoporosis? Tidsskr nor Laegeforen. 1998; 118: 575-9.
Ross PD, Kress BC, Parson RE, Wasnich RD, Armour KA, Mizrahi IA. Serum bone alkaline phosphatase and calcaneus bone density predict fractures: a prospective study. Osteoporos Int. 2000; 11: 76-82.
Streckfus CF, Bigler LR. Saliva as a diagnostic fluid. Oral Dis. 2002; 8: 69-76.
Taguchi A, Suei Y, Ohtsuka M, Otani K, Tanimoto K, Ohtaki M. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible. Dentomaxillofac Radiol. 1996; 25: 263-7.
Taguchi A, Suei Y, Sanada M, Ohtsuka M, Nakamoto T, Sumida H, et al. . Validation of dental panoramic radiography measures for identifying postmenopausal women with spinal osteoporosis. Am J Roentgenol. 2004; 183: 1755-60 .
Navazesh M. Methods for collecting saliva. Ann NY Acad Sci. 1993; 694: 72-77.
von Wowern N, Klausen B, Kollerup G. A risk factor in periodontal disease. J Periodontol. 1994; 65: 1134-8.
Hirai T, Ishijima T, Hashikawa Y, Yajima T. Osteoporosis and reduction of residual ridge in edentulous patients. J Prosthet Dent. 1993; 69: 49-56.
Humphries S, Devlin H, Worthington H. A radiographic investigation into bone resorption of mandibular alveolar bone in elderly edentulous adults. J Dent. 1989; 17: 94-96.
Jeffcoat MK, Lewis CE, Reddy MS, Wang CY, Redford M. Post menopausal bone loss and its relationship to oral bone loss. Periodontol 2000; 23: 94-102.
Klemetti E, Vainio P, Lassila V, Alhava E. Trabecular bone mineral density of mandible and alveolar height in post menopausal women. Scand J Dent Res. 1993; 101: 166-70.
Kribbs PJ, Smith DE, Chesnut CH, Oral findings in osteoporosis. Part II: Relationship between residual ridge and alveolar bone resorption and generalized skeletal osteopenia. J Prosthet Dent. 1983; 50: 719-24.
Kribbs PJ. Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent. 1990; 63: 206-14.
Ortman LF, Hausmann E, Dunford RG. Skeletal osteopenia and residual ridge resorption. J Prosthet Dent. 1989; 61: 321-5.
Elders PJ, Habets LL, Ntelembos 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; 19: 492-6.
Daniell H. Postmenopausal tooth loss. Contributions to edentulism by osteoporosis and cigarette smoking. Arch Intern Med. 1983; 143: 1678-82.
Krall EA, Dawson-Hughes B, Papas A, Garcia RI. Tooth loss and skeletal bone density in healthy postmenopausal women. Osteoporos Int. 1994; 4: 104-9.
Lundgren S, Rosenquist JB. Short term bone healing in calcium deficiency osteopenia and disuse osteopenia: Experimental studies in adult rats. Scand J Dent Res. 1992; 100: 337-9.
Taguchi A, Tanimoto K, Suei Y, Wada T. Tooth loss and mandibular osteopenia. Oral Surg Oral Med Oral Pathol. 1995; 79: 127-32.
Jacobs R, Ghyselen J, Koninckx P, van Steenberghe D. Long term bone mass evaluation of mandible and lumbar spine. Eur J Oral Sci. 1996; 104: 10-16.
Klemetti E, Vainio P. Effect of bone mineral density in skeleton and mandible on extraction of teeth and clinical alveolar height. J Prosthet Dent. 1993; 70: 21-5.
Klemetti E, Vainio P. Effect of maxillary edentulousness on mandibular residual ridges. Scand J Dent Res. 1994; 102: 309-12.
Klemetti E, Kolmakow S. Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofac Radiol. 1997; 26: 22-5.
Solar P, Ulm CW, Thornton B, Matejka M. Sex related changes in the bone mineral density of atropic mandibles. J Prosthet Dent. 1994; 71: 345-9.
Ulm CW, Solar P, Ulm MR, Matejka M. Sex related changes in the bone mineral density of atropic mandibles. Calcific Tissue Int. 1994; 54: 203-7.
Albright FA. Post menopausal osteoporosis JAMA. 1941; 116: 2465-74.
Jean Wactawski-Wende, Sara G, Grossi, Maurizio, Robert G. The role of osteopenia in oral bone loss and periodontal disease. J Periodontol. 1996; 67: 1076-84 35. Jeffcoat MK. Osteoporosis a possible modifying factor in oral bone loss. Ann Periodontol. 1998; 3: 312-21.
Nico C Geurs, Cora Elizabeth, Marjorie K. Osteoporosis and periodontal disease progression. Periodontol 2000. 2003; 32: 105- 10.
Ward VJ, Manson JD. Alveolar bone loss in periodontal disease and metacarpal index. J Periodontol. 1973; 44: 763-9.
Sewon L, Laine M, Karjalainen S, Doroguinskaia A, LehtonenVeromaa M. Salivary calcium reflects skeletal bone density of heavy smokers. Arch Oral Biol. 2004; 49: 355-8.
Sewon L, Laine M, Karjalainen S, Leimola-Virtanen R, Hiidenkari T, Helenius H. The effect of hormone replacement therapy on salivary calcium concentrations in menopausal women. Arch Oral Biol. 2000; 45: 201-6.
Pfeilschifter J, Köditz R, Pfohl M, Schatz H. Changes in proinflammatory cytokine activity after menopause. Endocr Rev. 2002; 23: 90–119.
Taguchi A, Sanada M, Krall E, Nakamoto T, Ohtsuka M, Suei Y, et al. . Relationship between dental panoramic radiographic findings and biochemical markers of bone turnover. J Bone Miner Res. 2003; 18: 1689-94
The Brazilian Journal of Oral Sciences uses the Creative Commons license (CC), thus preserving the integrity of the articles in an open access environment.