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Efficacy of Periodontal Disease and Tooth Loss to Screen for Low Bone Mineral Density in Japanese Women

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Abstract

The relationship between oral indicators and bone mineral density (BMD) has been studied by many investigators, with mixed and complex results. The purpose of the present cross-sectional study was to evaluate the associations of periodontal conditions and tooth loss with metacarpal BMD (m-BMD) in a community-based cohort and the usefulness of tooth count as a potential screening tool to detect low BMD. Subjects were 356 Japanese women (171 premenopausal, mean age 37.9 ± 8.0 years; 185 postmenopausal, mean age 63.3 ± 7.7 years). Periodontal status was evaluated by the Community Periodontal Index of Treatment Needs (CPITN). m-BMD was measured by computerized X-ray densitometry. The proportion of subjects with periodontitis (CPITN 3 or 4) increased as m-BMD decreased. The odds ratio (OR) of osteopenia or osteoporosis in relation to periodontitis was 3.2 (95% confidence interval [CI], 2.0–5.3). After adjustment for age and menopausal status, the OR was 2.0 (95% CI, 1.1–3.7). Among postmenopausal women, those having fewer than 20 teeth were 1.6 times more likely to have low m-BMD than those having more than 20 teeth (chi-square for trend in postmenopausal group, 4.27; P < 0.05). Receiver-operating curve (ROC) analysis indicated that number of teeth remaining or CPITN score had a greater than 50/50 chance to correctly identify women with osteoporosis or osteopenia, but the areas under the curve (0.72 and 0.67, respectively) are considered less than highly accurate screening tools. These results indicate that periodontitis and tooth loss after menopause may be useful indicators of m-BMD loss in Japanese women.

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Acknowledgement

The authors would like to acknowledge the assistance of Drs. Kazuhiro Noda, Hiroyasu Murata, Hirokatsu Asai, Yoshihiro Hasegawa, and Hiroshi Sumi of the Ichinomiya Dental Association for their support. This study was supported in part by a Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Science, Sports and Culture (No. 16390616) and the AGU High-Tech Research Center Project for Private Universities: matching fund subsidy from Ministry of Education, Culture, Sports, Science and Technology, 2003–2007. Dr. Garcia is supported by NIH Grant K24 DE00419 from the National Institute of Dental and Craniofacial Research

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Authors and Affiliations

  1. Department of Periodontology, School of Dentistry, Aichi-Gakuin University, 2-11 Suemoridori, Chikusa-ku, Nagoya, 464-8651, Japan

    K. Inagaki, Y. Kurosu, N. Yoshinari & T. Noguchi

  2. Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, Massachusetts, USA

    E. A. Krall & R. I. Garcia

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  1. K. Inagaki
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  2. Y. Kurosu
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  3. N. Yoshinari
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  4. T. Noguchi
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  5. E. A. Krall
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  6. R. I. Garcia
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Correspondence to K. Inagaki.

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Inagaki, K., Kurosu, Y., Yoshinari, N. et al. Efficacy of Periodontal Disease and Tooth Loss to Screen for Low Bone Mineral Density in Japanese Women. Calcif Tissue Int 77, 9–14 (2005). https://doi.org/10.1007/s00223-004-0275-x

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