Periodontal Disease and Osteoporosis-Shared Risk Factors and Potentiation of Pathogenic Mechanisms
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Purpose of Review
Periodontitis and osteoporosis are diseases which exhibit bone loss, quantifiable in the oral cavity and skeleton respectively. Accumulating evidence suggests that the two diseases interact with each other resulting in increased prevalence and more rapid disease progression. This review will explore if recent publications can elucidate the mechanisms by which this occurs.
Animal studies suggested that osteoporosis will accelerate the progression and severity of periodontitis. Most human studies have supported this association, mainly based upon radiographic measurements and to a lesser extent on clinical findings. They share several risk factors including age, genetics, hormonal changes, smoking, and calcium and vitamin D deficiency. Intriguingly, therapy aimed at one disease may have a positive impact upon the other disease.
This review examined recent literature and found evidence of a bidirectional relationship which facilitates communication in subjects diagnosed with periodontitis and osteoporosis promoting disease severity.
KeywordsPeriodontitis Osteoporosis Risk factors Disease progression
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 2.Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, et al. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. 2014;29(11):2520–6. https://doi.org/10.1002/jbmr.2269.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Schousboe JT, Shepherd JA, Bilezikian JP, Baim S. Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. J Clin Densitom. 2013;16(4):455–66. https://doi.org/10.1016/j.jocd.2013.08.004.
- 6.Looker AC, Borrud LG, Dawson-Hughes B, Shepherd JA, Wright NC. Osteoporosis or low bone mass at the femur neck or lumbar spine in older adults: United States-2005–2008. NCHS Data Brief. 2012;(93):1–8.Google Scholar
- 11.Iki M. Epidemiology of bone and joint disease—the present and future. Epidemiology of osteoporosis and osteoporotic fracture in Japan. Clin Calcium. 2014;24(5):657–64.Google Scholar
- 13.•• Page RC, Schroeder HE. Pathogenesis of inflammatory periodontal disease. A summary of current work. Lab Investig. 1976;34(3):235–49. This classic study was a histological analysis which depicted the progression of the disease from gingivitis (first three stages) to periodontitis (final stage) PubMedGoogle Scholar
- 15.Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci. 2017;11(2):72–80.Google Scholar
- 18.Fassio A, Rossini M, Viapiana O, Idolazzi L, Benini C, Vantaggiato E, et al. New strategies for the prevention and treatment of systemic and local bone loss; from pathophysiology to clinical application. Curr Pharm Des. 2017;Google Scholar
- 24.• Anbinder AL, Moraes RM, Lima GMG, Oliveira FE, Campos DRC, Rossoni RD, et al. Periodontal disease exacerbates systemic ovariectomy-induced bone loss in mice. Bone. 2016;83(2):241–7. This study demonstrated that the combination of experimental periodontitis and ovariectomy induced significantly more humoral and alveolar bone loss and was associated with elevated serum levels of IL-17. https://doi.org/10.1016/j.bone.2015.11.014.CrossRefPubMedGoogle Scholar
- 29.Tang ZL, Zhang WJ, Wang DX, Chen JM, Ma H, Wu D. An experimental study addressing promotion of mandibular defect repair through the intermittent subcutaneous injection of parathyroid hormone. J Oral Maxillofac Surg. 2014;72(2):419–30. https://doi.org/10.1016/j.joms.2013.07.037.CrossRefPubMedGoogle Scholar
- 40.Ronderos M, Jacobs DR, Himes JH, Pihlstrom BL. Associations of periodontal disease with femoral bone mineral density and estrogen replacement therapy: cross-sectional evaluation of US adults from NHANES III. J Clin Periodontol. 2000;27(10):778–86. https://doi.org/10.1034/j.1600-051x.2000.027010778.x.CrossRefPubMedGoogle Scholar
- 42.• Mau LP, Kuan YC, Tsai YWC, Lin JJ, Huynh-Ba G, Weng PW, et al. Patients with chronic periodontitis present increased risk for osteoporosis: a population-based cohort study in Taiwan. J Periodont Res. 2017;52(5):922–9. Large Taiwanese cohort study which demonstrated that periodontitis patients were at increased risk for being diagnosed with osteoporosis. https://doi.org/10.1111/jre.12464.CrossRefPubMedGoogle Scholar